Lupus and Dentistry – Effect of Lupus on Oral Health

Immune disorders are one of the deadliest diseases one can ever experience. During this time, the immune system attacks its body organs and tissues.

Several autoimmune diseases commonly affect the population. Some of these diseases include diabetes type I, rheumatoid arthritis, scleroderma, and inflammatory bowel disease.

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Lupus erythematosus is also one of the common autoimmune disorder that can have severe effects on your oral health.

Tooth decay, oral fungal infections, and mouth sores are among the common issues that people with lupus face.

The immunocompromised state of the person can lead to opportunistic infections that may affect the health of the teeth and oral tissues.

Moreover, medications used to treat lupus erythematosus causes chronic dry mouth and associated oral symptoms.

The treatment for oral symptoms often depends on the treatment of lupus. However, mouth ulcers and fungal infections can be treated symptomatically.

Today’s article will highlight the details about lupus erythematosus and its effects on oral health.

What is lupus?

Lupus erythematosus is an immune disorder which causes generalized inflammation of the body. The immune system attacks its body cells to breakdown and inflames gradually. (1)

The inflammation of the body may include the following organs and tissues –

  • Skin
  • Heart
  • Joints
  • Lungs
  • Brain
  • Kidneys

The prevalence of lupus is high among African American and Asian women between the age of 15-44 years. Lupus erythematosus is a potentially life-threatening disease with serious complications.

What are the signs and symptoms?

The signs and symptoms of lupus are unpredictable. Often, the symptoms occur and disappear on their own or persist for a long time.

Some of the common signs and symptoms of lupus may include –

  • Fever
  • Fatigue
  • Joint pain
  • Butterfly rash on the face
  • Skin Lesions
  • Dry eyes and mouth
  • Shortness of breath
  • Chest pain
  • Headache
  • Memory loss

Kidney problems may consist of nephritis where the person may experience high blood pressure, dark urine due to the presence of blood in the urine.

How does lupus affect oral health?

Lupus causes several oral issues. Typically, a person with lupus may develop red ulcers with a white halo, surrounded by white lines radiating out of the halo. These ulcers form on the lips, the roof of the mouth and inner cheeks. (2)

Tooth decay and temporomandibular joint inflammations are some of the common oral effects of lupus.

Other oral effects may include –

Periodontal disease

Lupus causes a variety of oral issues that get aggravated due to poor oral hygiene. Gum disease or periodontal disease is caused due to inflammation of the oral tissues as a result of an immune breakdown. (3)

Sometimes, swelling of the gums can potentially stimulate the inflammation of other parts in the body causing cardiovascular disease, diabetes, kidney disease and different forms of cancer.

Sjogren’s syndrome

This oral condition is typically caused by the medications used to treat lupus erythematosus. Sjogren’s syndrome is in an autoimmune disease which commonly causes dryness of eyes and mouth.

People with dry mouth lack saliva and often develop high levels of acid in the mouth. This acid attacks the surface of the teeth and causes rapid tooth decay. Development of mouth ulcers and mouth sores are additional oral effects that are associated with Sjogren’s syndrome.

Consequences of oral infections

The immunocompromised state produced by lupus erythematosus gives rise to the development of opportunistic infections in the mouth. Fungal infections like oral thrush and candidiasis are commonly associated with lupus. (4)

Sometimes bacterial infections may also develop in the mouth of a person with lupus. These bacterial infections pose the most significant threat to the overall health and well-being of an individual.

Research studies have shown that bacteria from the mouth can enter the body organs and cause potential harm to the body.

Typically, the bacteria can enter the body portals in two ways –

  • Bacteria residing in the gums can enter the saliva and be accidentally inhaled in the lungs. This incident may cause pneumonia or pulmonary infection.
  • Bacteria can also enter the circulatory system of the gums and travel around in the body causing secondary infections in various body organs.

How can lupus be treated?

Currently, lupus does not have a definite cure. However, medications like NSAIDs, antimalarial medications, corticosteroids, and immunosuppressive drugs can help to subside the symptoms.

Symptomatic treatment of oral problems may include –

  • Use of products that encourage the increased salivary flow
  • Drinking plenty of water to compensate for dry mouth
  • Diet modifications
  • Regular brushing and flossing of the teeth to maintain oral hygiene
  • Oral prednisone to subside the inflammation of oral tissues

Take away message

Lupus erythematosus is one of the common autoimmune disorders that causes inflammation of the body organs and tissues.

Moreover, lupus has a severe impact on oral health which may lead to the destruction of oral tissues at later stages.

Tooth decay, mouth ulcers, periodontal disease, and dry mouth, are some of the common oral effects of lupus erythematosus.

Oral infections associated with lupus may include both fungal and bacterial. The bacterial infections often spread into the body organs to cause possible life-threatening diseases.

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Treatment of lupus can only be symptomatic as there is no definitive cure for this autoimmune disease.

Pay attention to oral health to reduce the chances of dental decay and other oral problems. Problems with lupus and teeth can be a severe threat to your life.

Consult a team of doctors and dentist to treat the symptoms effectively and save yourself from the misery of lupus and its oral effects.

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