Navigating Dental Care and Oral Health Management Challenges in Sjögren's Syndrome: A Comprehensive Case Report with Literature Review

Autoimmune diseases encompass a wide range of conditions in which the immune system erroneously targets the body's own cells, leading to inflammation and tissue damage. Among these disorders, Sjögren’s syndrome holds particular significance in dentistry. This chronic condition primarily impacts exocrine glands, causing hallmark symptoms, such as xerostomia and keratoconjunctivitis sicca. Current research underscores the pivotal role of lymphocyte infiltration, particularly by T and B cells, in driving glandular dysfunction. Diagnostic markers, such as anti-SSA/Ro and anti-SSB/La autoantibodies, play a crucial role in confirming the condition. Furthermore, disruptions in microbial balance, or dysbiosis, are believed to exacerbate immune system dysregulation, further contributing to disease progression. This study presented the case of a 47-year-old female who has been diagnosed with Sjögren’s disease. Additionally, her medical history included complications from Stevens-Johnson syndrome, a stroke, trachoma, vitiligo, hypertension, and pre-diabetes. The objective of this study was to provide a detailed overview of the patient’s symptoms and treatment approach, emphasizing the impact of Sjögren’s syndrome on oral health and systemic complications.

This case study examined a 47-year-old female patient diagnosed with Sjögren’s syndrome, a chronic autoimmune condition characterized by the dysfunction of exocrine glands. Additionally, she presented many other medical conditions, which complicated her management. The patient presented with severe xerostomia and recurrent oral infections resulting from diminished salivary function. Laboratory findings indicated renal decline and elevated inflammatory markers, while a biopsy confirmed the diagnosis through lymphoid aggregates. This case underscores the multifaceted challenges in managing Sjögren’s syndrome, especially when accompanied by systemic involvement and multiple co-morbidities. The interplay between the autoimmune mechanisms of Sjögren’s syndrome and other conditions, such as Stevens-Johnson syndrome and vitiligo, creates a complex clinical scenario. Patients with Sjögren’s syndrome are at an increased risk for complications, including renal impairment, neurological issues, and a higher incidence of malignancies like non-Hodgkin’s lymphoma. Effective management requires a multidisciplinary approach, integrating specialists from various fields. Symptom relief is paramount, particularly for oral manifestations, as xerostomia can significantly impair quality of life. The patient's treatment included hydroxychloroquine to manage autoimmune responses and pilocarpine to stimulate saliva production. Regular monitoring of renal and liver functions, as well as inflammatory markers, is essential to prevent deterioration. Moreover, the presence of systemic inflammation, as indicated by elevated CRP levels, necessitates careful consideration of medication management to avoid exacerbating existing conditions. A comprehensive treatment strategy that addresses both the autoimmune components and the patient's broader health concerns is crucial for optimizing outcomes.

This case highlights the importance of individualized care, early detection, and comprehensive monitoring in patients with Sjögren’s syndrome. A comprehensive approach that accounts for the complexities of multiple co-morbidities can significantly improve quality of life and prevent further complications.