Autoimmune & Connective Tissue

Dental Management of Patients with Sjögren's syndrome

Sjögren's — aggressive dry-mouth management

Reduced salivary flow markedly raises caries, candidiasis and mucosal-trauma risk. Persistent salivary gland enlargement warrants lymphoma vigilance.

Emergency vs routine management

If EMERGENCY — what to do

• Treat normally; manage candidiasis and rampant caries.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023

If ROUTINE — what to do

• High-fluoride toothpaste, saliva substitutes, sialogogues via physician, 3-monthly recall.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023

Clinical precautions

• High caries risk: topical fluoride, saliva substitutes, sugar-free salivary stimulants
• Examine for candidiasis and mucosal trauma; treat promptly
• Persistent unilateral gland swelling — refer to exclude lymphoma
• Review current corticosteroid / methotrexate / biologic therapy
• Consider stress-dose steroids for major surgery (see the steroid-cover note)
• Meticulous infection control

Information & tests to request

• Daily prednisolone-equivalent dose (mg) — This patient's condition/therapy is commonly associated with long-term corticosteroids, which can suppress the adrenal response to surgical stress. Enter the daily dose (0 if none) to determine whether supplementary stress-dose cover is needed.

At a glance by procedure

Initial assessment before lab results or timing details are entered.

Procedure	Initial assessment
Examination / radiographs	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management
Supragingival scaling / polish	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management
Deep scaling / subgingival RSD (subgingival calculus)	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management
Root canal treatment	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management
Simple extraction (1–3 teeth)	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management
Surgical / bony extraction	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management
Implant placement	MODIFY / CAUTION Sjögren's — aggressive dry-mouth management

Get a patient-specific decision in seconds

Combine all conditions, medications, lab results and the planned procedure — with anaesthetic dose calculation, lab requests and a referral letter PDF.

References

Autoimmune / connective tissue disease — dental management
Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023

This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.