A persistent feeling of dryness in the eyes and mouth can be a sign of Sjogren’s syndrome. First identified in the 1930s by Swedish ophthalmologist Henrik Sjogren, the condition was initially linked to rheumatoid arthritis in some patients.
Today, we know Sjogren’s syndrome is an autoimmune disorder primarily marked by dry eyes and a dry mouth. It often occurs alongside other autoimmune diseases, such as lupus or rheumatoid arthritis.
Like other autoimmune conditions, the problem arises when the body mistakenly attacks its own tissues. In Sjogren’s syndrome, this targets the mucous membranes and the glands that produce tears and saliva, leading to the hallmark symptoms of eye and mouth dryness.
Who Is Affected
Sjogren’s syndrome can affect anyone at any age, but it is most often diagnosed in people over 40. Women are particularly at risk, being nine times more likely than men to develop the condition.
After rheumatoid arthritis and systemic lupus erythematosus, Sjogren’s is the most common autoimmune rheumatic disease, affecting roughly 0.4-0.6% of the population.
Risk factors include having a first-degree relative with an autoimmune disease or having an autoimmune condition yourself. This aligns with the initial studies conducted by the syndrome’s discoverer, who linked it to rheumatoid arthritis: Sjogren’s syndrome occurs in 30-50% of people with rheumatoid arthritis and in 10-25% of patients with systemic lupus erythematosus.
Symptoms
The main symptoms of Sjogren’s syndrome affect the eyes and mouth, causing pronounced dryness of the mucous membranes. In the eyes, this results in reduced tear production, leading to poor lubrication and discomfort.
In the mouth, Sjogren’s syndrome causes xerostomia, or dry mouth. This condition can present in several ways: you might feel that food – especially dry items like bread or crackers – sticks in your mouth or throat due to reduced lubrication, or you may experience increased thirst and the need to drink during meals to help with swallowing. It can also affect your sense of taste, often causing a bitter or metallic sensation, and may lead to inflammation or numbness of the tongue. Xerostomia can affect the overall health of the mouth, leading to issues such as gum inflammation, an increased risk of cavities, and heightened susceptibility to bacterial and fungal infections. These problems are directly linked to insufficient saliva production.
Saliva plays a crucial role in maintaining the mouth’s pH balance. After meals, the oral environment tends to become acidic, but within about forty minutes, saliva normally neutralizes the pH. When saliva production is insufficient, however, this buffering effect is weakened, and the mouth remains in a state of constant acidity. This persistent acidic environment is harmful not only to the teeth – leading to demineralization, enamel erosion, sensitivity, and increased susceptibility to bacterial attack – but also to the oral mucosa, as harmful microorganisms thrive in acidic conditions, increasing the risk of cavities, mouth ulcers, and fungal infections such as oral thrush.
Treatment and Management
There is currently no cure for Sjogren’s syndrome, but symptoms can be managed. Consult your doctor for a proper diagnosis and personalized treatment plan.
For dry eyes, artificial tears or medicated eye drops may be prescribed.
To relieve the discomfort of xerostomia, lifestyle changes can be very helpful. For example, smoking irritates and dries out the oral mucosa, so quitting smoking is essential for maintaining the health of your mouth – and your overall well-being.
Drinking plenty of fluids can help relieve the constant thirst and dry mouth caused by Sjögren’s syndrome. Be sure to choose drinks that are neither sugary nor acidic (such as many sodas), as these can damage your teeth and make your mouth more prone to fungal infections. Alcohol and coffee should also be avoided, as they can worsen dry mouth.
Whenever possible, try to breathe through your nose rather than your mouth. A blocked nose due to a cold or allergies may force you to breathe through your mouth, which can worsen dryness in the oral mucosa. In such cases, using a saline spray can help clear your nasal passages and restore proper breathing.
As we’ve seen, maintaining good oral hygiene is essential for those with Sjögren’s syndrome. To reduce the risk of cavities and gum disease, brush your teeth after every meal, use dental floss regularly, and keep up with routine dental check-ups. Adding antibacterial mouthwashes or sprays to your routine can further support oral health. These practices help maintain a neutral pH in the mouth, keeping it healthier overall.
Low saliva production, as mentioned, is one of the main symptoms of the disease. Restoring proper salivary function is an important step in combating oral dryness. It is possible to stimulate saliva production by using sugar-free candies or chewing gum, which won’t increase the risk of cavities. When this isn’t sufficient or feasible, salivary substitutes are recommended: acting as “artificial saliva,” these products are more effective than water at restoring proper mucosal hydration, thanks to ingredients that provide longer-lasting lubrication.
In this context, Cariex® can be a great ally: this dental spray is designed to adhere to the oral mucosa, providing immediate relief from dry mouth discomfort. Thanks to the bicarbonate in its formulation, Cariex® helps restore the mouth’s pH, reducing the risk of cavities; xylitol provides antibacterial and anti-inflammatory benefits, while hyaluronic acid enhances mucosal hydration and supports healing.
Using Cariex® after every meal instantly reduces oral acidity. Acting as a saliva substitute, Cariex® also helps restore a neutral pH in the mouth, keeping it healthier and stronger against infections.