Treatment of oral symptoms in Sjögren's syndrome.

The most pronounced oral symptoms in Sjögren's syndrome are a dry sensation of the mouth and difficulties in swallowing and speech. Besides these patients do no 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 neural 1% sodium fluoride gel. Prophylaxis of candidosis can be obtained by meticulous oral hygiene and removal of predisposing factors (e.g. poor dentures). For the other oral signs of Sjögren's syndrome only a symptomatic treatment is possible, because damage of salivary gland tissue is progressive and irreversible. Good results can be obtained by applying a mucin-containing saliva substitute, which has been shown to reduce the dry an burning sensation of the mouth as well as to improve chewing, swallowing, speech and sleeping. When applied by an atomizer it wets the oral cavity for about 30 min. A continuous wetting can be obtained using intra-oral artificial saliva reservoirs.