In the early 1900s, Swedish physician Henrik Sjögren (SHOW-gren) first described a group of women whose chronic arthritis was accompanied by dry eyes and mouth. Sjögren syndrome, also called Sjogren's syndrome, is a chronic autoimmune condition mainly affecting the salivary and tear glands. An autoimmune condition is when the body attacks parts of itself, like arthritis (joints) and type I diabetes (pancreas). Because Sjogren's syndrome causes mouth dryness, which leads to tooth decay, gum disease, difficulty swallowing, and pain, dentists are trained to recognize it.

Who Gets Sjogren's Syndrome?

The prevalence of Sjogren's is about .5-1% of the population, which is about half the amount of rheumatoid arthritis, so it is not rare. Women are affected nine times more than men, similar to Lupus, which also targets women. There are no other patterns of susceptibility. It usually becomes noticeable in middle age, around 45 to 55. Interestingly, half of the people with it also have rheumatoid arthritis. 

What Are The Symptoms?

Since our immune system attacks the salivary and tear (lacrimal) glands, dry eyes and mouth are the major symptoms. In addition, the salivary glands on the cheeks can appear swollen and hard. The skin, respiratory tract, and vagina can also become dry and inflamed. Multiple other symptoms can also occur. Fatigue is a common complaint. Up to one-half of affected individuals also involve symptoms in organs such as the joints, skin, lungs, GI tract, nervous system, and kidneys. The combination of complaints is called sicca syndrome. Many conditions, especially fibromyalgia, can mimic the sicca symptoms of Sjogren's, so a differential diagnosis is important. You can click here for a complete list of sicca symptoms. 

How is it Diagnosed?

The best way to diagnose Sjogren's syndrome is through a minor lip salivary gland biopsy. The presence of lymphocytic tissue is 82% accurate. Salivary and tear flow rates are also useful. Additionally, eye doctors can use special stains in the eye to test for it. Blood analysis is also standard. Antibodies against La/SSB are considered a highly specific diagnostic marker for Sjögren syndrome, so their presence, including some of the other features of Sjogren's, are considered diagnostic. 

How is it treated?

Unfortunately, Sjogren's syndrome is not curable. However, since 90% of cases are mild, palliative treatments are a good option. Dry eyes usually respond to artificial tears applied regularly during the day or to gels applied at night. Plugging up the tear duct, a punctal plug, is also a good option. Restasis is an eye drop that helps us produce more tears. Drinking water, chewing gum, or using saliva substitutes may relieve dry mouth.

Some medications, such as pilocarpine, can help us produce more saliva. In addition, humidifiers and nasal saline irrigation may improve nasal dryness. Monoclonal antibodies can help, but patients must be closely monitored for cancer. Finally, low-dose naltrexone may help patients manage their illness. 

The Bottom Line

It is important to visit your dentist regularly because low salivary flow can lead to much higher rates of tooth decay, tooth erosion, and wear. In addition, if you have been experiencing dry mouth or eyes, you should visit your dentist and eye doctor to rule out Sjogren's syndrome. Most importantly, eat whole foods while minimizing or eliminating processed carbohydrates and vegetable oils like soybean.

  Source:

Mavragani CP, Moutsopoulos HM. Sjögren syndrome. CMAJ. 2014 Oct 21;186(15):E579-86. doi: 10.1503/cmaj.122037. Epub 2014 Feb 24. PMID: 24566651; PMCID: PMC4203623.