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Sjögren’s Syndrome

  • Frequent recalls to address increased caries risk, mainly due to hyposalivation
  • Emphasis on good oral hygiene
  • Frequent fluoride applications
  • Encourage frequent hydration
  • Encourage avoidance of coffee, alcohol and tobacco products
  • Encourage use of sugar-free gums
  • Increase salivary flow with systemic sialologues:
    pilocarpine – 5 mg tid; start with 2.5 mg bid, increase by small increments at intervals of 4-6 weeks. Do not exceed 10 mg/dose to a maximum of 30 mg/day;
    cevimeline – 30 mg tid; start with a lower dosage and increase incrementally;
    bethanecol – 10 to 50 mg tid or qid; start with a lower dosage and increase incrementally.
    Side-effects may include increased urinary frequency, increased sweating, flushing, headaches, nausea, and abdominal pain. To reduce side-effects,medications should be taken 1 hour before or 2 hours after meals.
  • Enhance oral discomfort with lubricating gels and mucin sprays
  • Recognize and treat oral candidiasis
  • Suggest the use of humidifiers at night, avoid dry and smoky environments

OK