What are the oral signs of Sjögren syndrome?

Updated: Mar 05, 2021
  • Author: Sriya K Ranatunga, MD, MPH; Chief Editor: Herbert S Diamond, MD  more...
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Oral signs include the following:

  • Dryness

  • Tongue - Red, smooth, and dry (see the image below)

  • Dental caries - Severe and progressive

  • Parotid duct narrowing

  • Lips - Red, dry, and scaly

  • Cracks at the corners of the mouth

  • Chronic oral candidiasis

    Dryness of the mouth and tongue due to lack of sal Dryness of the mouth and tongue due to lack of salivary secretion is characteristic of xerostomia associated with Sjögren syndrome. Mouth dryness may produce a deep red tongue, as shown here, and dental caries are common.

Look for a decreased sublingual salivary pool. The tongue may stick to the tongue depressor. Patients with Sjögren syndrome may develop frequent caries, sometimes in unusual locations such as the incisor surface and the gum line.

Patients with Sjögren syndrome are prone to develop oral candidiasis. In addition to white patches, watch for petechial lesions, loss of tongue papilla, erythema and fissuring of the tongue, erythema on other mucosal surfaces, and angular cheilosis. Oral candidiasis can be seen under dentures.

Gingival inflammation has been found to be more evident in the individuals with Sjögren syndrome, particularly those with secondary Sjögren syndrome. [53] Periodontal disease can lead to loss of teeth.

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