Management of the oral features of Sjögren's syndrome.

In this paper the basis of the oral features of Sjögren's syndrome is described and guidelines for proper management of these features are given. The most pronounced oral symptoms are a dry sensation in the mouth and difficulties with swallowing and speech. Furthermore, these patients do not sleep well and may complain about burning mucous membranes, rampant caries and candidosis. Rampant caries can be prevented by optimal oral hygiene and frequent applications of a fluoride gel. Prophylaxis of candidosis can be achieved by meticulous oral hygiene and removal of predisposing factors (e.g. poorly fitting dentures). It is only possible to treat the other oral signs of Sjögren's syndrome symptomatically, because damage of salivary-gland parenchyma is progressive and irreversible. In the early stages of Sjögren's syndrome, good results can be obtained by gustatory or pharmacological stimulation of the salivary secretion. In the more advanced stages, the patient has to resort to oral rinses and saliva substitutes, the majority of which are not satisfactory. Promising results have been obtained with mucin-containing lozenges.