Oral health education for systemic sclerosis patients: A booklet report

Almeida, Thalles G.; Ferreira, Alessandra R.H.; Silva, Felipe S. da; Chaves, Caio Carvalhais; Assunção, Bárbara N.; Martins, Priscila S.; Dores, Alessandra S. das; Moura, Regina M.F. de; Andrade, Juliana Alves de; Santos, Flávia Patrícia Sena Teixeira; Ferreira, Gilda Aparecida; Calderaro, Débora Cerqueira

doi:10.1016/j.pecinn.2023.100154

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…Microstomia was observed in 52% to 80% of SSc patients ( Gonzalez et al 2021 ) and has been related to disease severity ( Baron et al 2015 ). Microstomia significantly impairs SSc patients’ food intake and promotes the onset of malnutrition by hindering their abilities in mastication and deglutition, adversely impacts SSc patients’ abilities to maintain oral hygiene, and limits the abilities of dental practitioners to provide proper oral examinations or dental treatments ( Veale et al 2016 ; Almeida et al 2023 ). Interestingly, compared to lcSSc patients, microstomia is significantly more evident in dcSSc, contributing to a 2.5 times higher Mouth Handicap in the SSc Scale (MHISS) score, significantly impacting their oral health–related quality of life (OHRQoL) ( Jung et al 2023 ).…”

Section: Orofacial Implications Of Sscmentioning

confidence: 99%

“…Collectively, the etiology of the altered periodontal conditions in SSc is unclear and potentially multifactorial. The factors include, xerostomia, restricted ability to maintain oral hygiene due to microstomia, oral microbiome alterations, microangiopathy, immune dysregulation, and pathological ECM remodeling associated with SSc ( Baron et al 2015 ; Almeida et al 2023 ; Jud et al 2023 ).…”

Section: Orofacial Implications Of Sscmentioning

confidence: 99%

“…Furthermore, a reduction in salivary flow, resulting in xerostomia, is primarily attributed to salivary gland fibrosis ( Avouac et al 2006 ). Xerostomia increases the susceptibility of SSc patients to periodontitis, tooth decay, and erosion by reducing saliva’s capacity to buffer the heightened oral acidity resulting from bacterial activity and SSc-associated gastroesophageal reflux ( Almeida et al 2023 ).…”

Section: Orofacial Implications Of Sscmentioning

confidence: 99%

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Orofacial Complications of the Connective Tissue Disease Systemic Sclerosis

Sharma,

Fadl,

Leask

2024

J Dent Res

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Scleroderma (systemic sclerosis, SSc) is an autoimmune fibrosing connective tissue disease of unknown etiology. SSc patients show increased levels of autoantibodies, profibrotic cytokines, and extracellular matrix remodeling enzymes that collectively cause activated (myo)fibroblasts, the effector cell type of fibrosis. Despite these impacts, no disease-modifying therapy exists; individual symptoms are treated on a patient-to-patient basis. SSc research has been principally focused on symptoms observed in the lung and skin. However, SSc patients display significant oral complications that arise due to fibrosis of the not only skin, causing microstomia, but also the gastrointestinal tract, causing acid reflux, and the oral cavity itself, causing xerostomia and gingival recession. Due to these complications, SSc patients have impaired quality of life, including periodontitis, tooth loss, reduced tongue mobility, and malnutrition. Indeed, due to their characteristic oral presentation, SSc patients are often initially diagnosed by dentists. Despite their clinical importance, the oral complications of SSc are severely understudied; high-quality publications on this topic are scant. However, SSc patients with periodontal complications possess increased levels of matrix metalloproteinase-9 and chemokines, such as interleukin-6 and chemokine (C-X-C motif) ligand-4. Although many unsuccessful clinical trials, mainly exploring the antifibrotic effects of anti-inflammatory agents, have been conducted in SSc, none have used oral symptoms, which may be more amenable to anti-inflammatory drugs, as clinical end points. This review summarizes the current state of knowledge regarding oral complications in SSc with the goal of inspiring future research in this extremely important and underinvestigated area.

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Section: Orofacial Implications Of Sscmentioning

confidence: 99%

Section: Orofacial Implications Of Sscmentioning

confidence: 99%

Section: Orofacial Implications Of Sscmentioning

confidence: 99%

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Orofacial Complications of the Connective Tissue Disease Systemic Sclerosis

Sharma,

Fadl,

Leask

2024

J Dent Res

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“…A very recent meta-analysis including some of the above-mentioned reports highlighted that periodontitis was more common in SSc patients [odds ratio (OR) 7.007; 95% confidence interval (CI) 3.529, 13.915)] and was associated with more changes of clinical parameters such as probing depth (PD) [standard mean difference (SMD) 3.101; 95% CI 1.374, 4.829] and clinical attachment loss (CAL) (SMD 2.584; 95% CI 0.321, 4.846) [ 2 ]. The large heterogeneity in characterization of the periodontal state in terms of periodontal parameters [ 9 , 10 , 11 , 18 ] and the different or inconsistent periodontitis case definitions [ 12 , 13 , 14 , 15 , 16 , 19 , 20 ] make comparisons or estimations of periodontitis frequency in SSc patients difficult, while also complicating the design of coherent prophylactic approaches to efficiently reduce the adverse oral effects of SSc [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Insights into the Relationship between Periodontitis and Systemic Sclerosis Based on the New Periodontitis Classification (2018): A Cross-Sectional Study

Ciurea,

Stanomir,

Șurlin

et al. 2024

Diagnostics

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(1) Background: This study aimed to assess the periodontitis burden in systemic sclerosis patients and the possible association between them, and the degree to which some potential risk factors and two potential diagnostic biomarkers may account for this association. (2) Methods: This cross-sectional study included a test group (systemic sclerosis patients) and a control group (non-systemic sclerosis patients). Both groups benefited from medical, periodontal examination and saliva sampling to determine the salivary flow rate and two inflammatory biomarkers (calprotectin, psoriasin). A systemic sclerosis severity scale was established. (3) Results: In the studied groups, comparable periodontitis rates of 88.68% and 85.85%, respectively, were identified. There were no significant differences in the severity of periodontitis among different systemic sclerosis severity, or in the positivity for anti-centromere and anti-SCL70 antibodies. Musculoskeletal lesions were significantly more common in stage III/IV periodontitis (n = 33, 86.84%) than in those in stage I/II (n = 1, 100%, and n = 3, 37.5%, respectively) (p = 0.007). Comparable levels of the inflammatory mediators were displayed by the two groups. There were no significant differences in calprotectin and psoriasin levels between diffuse and limited forms of systemic sclerosis. (4) Conclusions: Within the limitations of the current study, no associations between systemic sclerosis and periodontitis, or between their risk factors, could be proven.

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