Sicca Symptoms, Oral Health Conditions, Salivary Flow and Oral Candida in Sjögren’s Syndrome Patients

Abstract

This study aimed to investigate the relationships among sicca symptoms, oral health conditions, salivary profiles and oral Candida in Sjögren’s syndrome (SS) patients. Eighty-five SS patients (mean age = 50.5) and 40 healthy non-SS individuals (mean age = 51.4) were recruited. They self-completed the Sicca Symptoms Inventory (SSI). Decayed, missing and filled surface (DMFS) scores, salivary flow rates, pH and oral Candida colonization were determined. Mean SSI summary scores of SS patients and non-SS individuals were 11.1 and 5.4 respectively (p < 0.001). The most prevalent sicca symptoms in SS patients were eye irritation (93%), dry throat or nose (88%) and need of fluid for mouth wetting (88%). SS patients had significantly lower whole salivary flow rates than the non-SS individuals. Candida strains were isolated from over 60% of SS patients but not in non-SS patients. C. albicans was the predominant species. SSI summary score was negatively correlated to salivary flow rates while SSI summary and domain scores were positively correlated to the number of filled surfaces (FS) and DMFS scores and oral Candida counts. In conclusion, SS patients had more severe sicca symptoms than non-SS individuals. SSI scores were negatively correlated to the salivary flow rates but positively correlated to caries experience and oral Candida colonization.

A relevância da Síndrome de Sjögren na Oftalmologia e Odontologia e sua correlação com a qualidade de vida dos pacientes

“…Nos artigos selecionados, nota-se que as manifestações clínicas sistêmicas e orais mais prevalentes consistiram em irritação nos olhos e garganta, nariz, boca, vagina e pele seca, disgeusia, sensações de queimação na língua, halitose, periodontite e lesões cariosas, ocasionando tosse crônica, dificuldade para alimentar, necessidade de umidificar a cavidade bucal e ocular constantemente, dor no ato sexual, coceira no corpo, perda dentária e impactos sociais, afetando diretamente a qualidade de vida desses pacientes [ (Albrecht et al, 2016); (Berman et al, 2019); (Rusthen et al, 2017); (Xin et al,2020)]. Além disso, os níveis baixos do fluxo salivar encontrados apresentaram correlação com o desenvolvimento de candidíase oral (Xin et al,2020) e relação com a presença de maior quantidade de placa bacteriana e índice gengival em pacientes com SS-p, uma vez que essa alteração influência na função da saliva como a primeira linha de defesa contra o ataque bacteriano e viral à cavidade oral (Reyes et al, 2021). Porém a hipossalivação não foi suficiente para explicar o excesso de risco de lesões cariosas e a presença de disgeusia, sensações de queimação na língua e halitose observados nos pacientes com SS, reforçando a necessidade de mais estudos [ (Berman et al,2019); (Rusthen et al, 2017)].…”

“…Xin et al (2020) destacaram a relação entre os sintomas de sicca, condições de saúde bucal, perfis salivares e a cândida oral em pacientes com SS. Os sintomas de sicca foram altamente prevalentes em pacientes com SS, relatando mais manifestações nos domínios oral, ocular, vaginal, cutâneo e respiratório que os controles.…”

High-Throughput Sequencing of Oral Microbiota in Candida Carriage Sjögren’s Syndrome Patients: A Pilot Cross-Sectional Study

“…In one study, 87.5% of hyposalivation patients were colonized by Candida , which was isolated from saliva, with the majority (80.6%) being C. albicans [ 21 ]. For SS patients lacking saliva-mediated prevention of Candida adhesion to the mucosa [ 22 ], oral signs of candidiasis were evident in 13.1% to 60% of SS patients [ 23 , 24 ], which was significantly higher than the rate of candidiasis in healthy controls [ 25 ]. During the past decade, there has been increased recognition of the synergistic or antagonistic interactions between oral Candida and the oral microbiota [ 26 , 27 ].…”

Oral Health and Oral Health-Related Quality of Life in Patients with Primary Sjögren’s Syndrome

“…Saliva plays an essential part in maintaining and protecting oral health, so the decrease in its quantity and quality leads to chronic oral discomfort alongside a broad spectrum of problems [ 6 ]. Some of the most common oral manifestations associated with pSS are dental caries, atrophy of the oral mucosa, glossitis, oral ulcers, and fungal infections [ 7 , 8 , 9 ]. Due to hyposalivation, patients frequently experience chewing, swallowing, and speaking difficulties [ 8 ].…”

“…Due to hyposalivation, patients frequently experience chewing, swallowing, and speaking difficulties [ 8 ]. Additional issues include chemosensory dysfunction, halitosis, and trouble wearing dentures [ 8 , 9 ].…”