Treatment of xerostomia in Sjögren's syndrome - what effect does it have on the oral microbiome?

Sjögren's syndrome is an autoimmune disease characterized by lymphatic infiltration of secretory tissues. The disease results in dryness of the eyeball or mouth, which often occur simultaneously. Agents used to treat Sjögren's syndrome may improve oral hydration and the patient's quality of life. There are several pharmacological and non-pharmacological agents used to treat significant problem like xerostomia. The use of appropriate medicines (i.e. pilocarpine and cevimeline) may cause changes in the local microbiome, which is very sensitive to quantitative changes in water. As a result of Sjögren's syndrome, a new balance of the microbiome is established in the oral cavity, which, if disturbed by medical measures, may increase the risk of oral lesions (such as periodontopathies or caries) or reduce this risk. Overall, the knowledge regarding microbiological aspects and agents treating oral dryness is still not well described but initial results indicate some microbial alterations.