The effect of pilocarpine on dental caries in patients with primary Sjögren’s syndrome: a database prospective cohort study

Abstract

BackgroundPrimary Sjögren’s syndrome (pSS) is associated with dental caries. Pilocarpine, a salivary stimulant, can improve the amount and flow rate of saliva in patients with pSS. This study aimed to assess whether the risk of dental caries decreases with the use of pilocarpine in patients with pSS.MethodsFor this prospective cohort study, we identified pSS patients from the catastrophic illnesses registry of the National Health Insurance Research Database of Taiwan between 2009 and 2013. We divided participants into pilocarpine and non-user groups based on the pilocarpine prescriptions available during the first 3-month follow-up. The primary endpoint was dental caries. The secondary endpoints were periodontitis and oral candidiasis. We compared the risk of these oral manifestations using the Cox proportional hazard model.ResultsA total of 4973 patients with new-onset pSS were eligible for analysis. After propensity score matching, we included 1014 patients in the pilocarpine group and 2028 patients in the non-user group. During the mean follow-up of 2.6 years, the number of events was 487 in the pilocarpine group (48.0%) and 1047 in the non-user group (51.6%); however, the difference was not significant (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.82 to 1.06). Furthermore, there was no significant difference between groups regarding risk of periodontitis (HR 0.91, 95% CI 0.81 to 1.03) and oral candidiasis (HR 1.16, 95% CI 0.70 to 1.94).ConclusionPilocarpine may have no protective effect on dental caries, periodontitis, or oral candidiasis in patients with pSS.

Increased risk of developing dental diseases in patients with primary Sjögren’s syndrome—A secondary cohort analysis of population-based claims data

“…Therefore, it is crucial to prevent the development dental diseases and their sequel. Currently, muscarinic agonists (pilocarpine hydrochloride and cevimeline hydrochloride) are commonly used to increase saliva section for controlling oral dryness [ 2 ], but the protective effect of these agents on dental caries and periodontitis was still equivocal [ 20 ]. Topical fluoride can effectively decrease dental caries in patients with pSS [ 21 ].…”

Association Between Subjects with Newly Diagnosed Rheumatoid Arthritis and Dental Caries

“…One of the main bacteria associated with caries is the streptococcus mutans, however, a wide ODOVTOS-International Journal of Dental Sciences variety of microorganisms that intervene in dental caries have been identified by various researchers (25,26). Poor dental hygiene habits, alterations in saliva, systemic diseases, socioeconomic factors, age, gender and nutrition are some of the variables related to the presence of cavities (5)(6)(7)(8)27).…”

“…Osteoarthritis in fingers and hands and 8. General osteoarthritis causing severe immobility in the patient (5)(6)(7)(8)(9)10,12,(31)(32)(33)(34).…”

“…The dry mouth symptom is caused mainly by the alteration of the salivary glands. This is due to a lymphocytic infiltration of the glandular tissue and the presence of autoantibodies that end up causing cellular and tissue damage to the glandular tissue (7).…”

Candida Infection as an Early Sign of Subsequent Sjögren's Syndrome: A Population-Based Matched Cohort Study

“…The diagnosis was based on the classification criteria established by the European Community Study Group in 1993 (15). The ICD coding algorithm was used (16). All the participants were followed until the confirmed diagnosis of SjS, their death, or the end of 2013.…”