Your mouth may feel chalky, and you may have trouble swallowing, speaking, and tasting. Because you lack the protective effects of saliva, you may develop more dental decay (cavities) and mouth infections, such as candidiasis (also called thrush).
The most common symptoms are dry mouth and dry eyes. Specific oral manifestations associated with Sjögren disease may include increased risk of caries, gingivitis, oral candidiasis, enlarged salivary glands, and others.
Sjogren's Syndrome
According to Dr. Cram, the signature white spots of thrush may appear. Or, your tongue may become red and smooth if the little hairs disappear. Some people with Sjögren's syndrome also have a burning sensation and cracking of the tongue.
Dentists are usually the first to diagnose Sjogren's syndrome due to its adverse effects on dental health. The syndrome primarily affects salivary glands located in the mouth leading to reduced saliva flow.
As a result, people with Sjögren's disease have dry mouth and dry eyes. Dry mouth affects taste, makes chewing and swallowing more difficult, and increases the risk for cavities, tooth loss, and infections in the mouth.
The main symptoms are dry eyes and mouth, but other parts of the body may be affected as well, with many people reporting fatigue and joint and muscle pain. In addition, the disease can damage the lungs, kidneys, and nervous system.
We divided SS patients into three stages: stage I is glandular SS, stage II is extraglandular SS, and stage III is extraglandular SS with lymphoid malignancy.
The neurological complications of Sjögren's syndrome are extensive and range from cognitive difficulties, to burning toes and feet.
Dry eyes, corneal ulcerations and infections. Dry nose, recurrent sinusitis, nosebleeds. Dry mouth, mouth sores, dental decay, difficulty with chewing, speech, taste and dentures. Swollen, painful parotid/salivary glands.
Due to decreased tear production, your eyes may feel extremely dry. They may also itch or burn, leading to excessive blinking. It may feel like grains of sand are lodged in your eyes. Or they may be red or watery, and you may have blurred vision or be sensitive to bright or fluorescent lights.
Blood and urine tests, to look for the presence of antibodies common in Sjögren's syndrome. The results of an ANA (antinuclear antibody) test will determine if you have an autoimmune disorder. Schirmer's test, to see if your tear glands are producing enough tears to keep your eyes moist.
Primary Sjögren's syndrome
Certain people are born with specific genes that make them more vulnerable to a faulty immune system. Then, many years later, an environmental factor, possibly a common virus, triggers the immune system to stop working properly. The female hormone oestrogen also seems to play a role.
For dry eye and dry mouth, doctors may prescribe pilocarpine hydrochloride or cevimeline, both of which stimulate the lacrimal glands to produce more tears and the salivary glands to create more saliva. Both medications are taken by mouth three times a day.
Most individuals with Sjögren syndrome present with sicca symptoms, such as xerophthalmia (dry eyes), xerostomia (dry mouth), and parotid gland enlargement, which is seen in the image below. (See Presentation.) Marked bilateral parotid gland enlargement in a patient with primary Sjögren syndrome.
Age: Most people who are diagnosed with Sjögren's syndrome are 40 or older, but it can affect younger individuals, including children. Gender: Women are as much as 10 times more likely to develop Sjögren's syndrome than men. This imbalance may be related to the effect of sex hormones on a woman's immune system.
In most people with Sjögren syndrome, dry eyes and dry mouth are the primary features of the disorder, and general health and life expectancy are largely unaffected.
Salivary gland tests can measure how much saliva your mouth produces. Ultrasound imaging and biopsy can help determine if the salivary gland tissues are altered by inflammation. Blood tests can identify antibodies that are typically present in people with Sjögren's syndrome and other autoimmune disorders.
Global cognitive impairment in Sjögren's
Most patients experience “brain fog” symptoms, which manifest as memory lapses, forgetfulness, mental confusion, and difficulties in concentrating, organizing, or anticipating future events.
Studies indicate that Sjogren's patients experience more physical fatigue than mental fatigue. These patients also report intense daytime sleepiness, an indicator of physical exhaustion. Some who suffer may experience severe symptoms, while others have mild symptoms.
Because your body has trouble producing saliva, you may experience difficulty swallowing when symptoms flare up. Your mouth may feel chalky, and you may have trouble swallowing food. Many people with Sjogren's develop cavities and oral infections.
There are several infectious agents that are suspected to play significant roles in the development of SS, such as cytomegalovirus (CMV), Epstein–Barr virus, hepatitis C virus, human T-cell lymphotropic virus-1 (HTLV-1), Staphylococcus saccharolyticus, and Heliobacter pylori (Table 2).
Sjögren's syndrome can also cause swollen or painful joints, muscle pain or weakness, dry skin, rashes, brain fog (poor concentration or memory), numbness and tingling sensations in the arms and legs due to nerve involvement, heartburn, kidney problems and swollen lymph nodes.