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    Lupus and dental issues Lupus and dental issues Presentation Transcript

    • Lupus and the Mouth Stuart A . Green MD Chief of Rheumatology
    • ACR Criteria
    • Acr criteria
    • SLE
      • Oral Ulcers
      • Dry Mouth (Sicca)
      • Infections
      • Medications
    • Oral Ulcers
      • Hard Palate; tongue and buccal mucosa
      • Painless typically, but can be painful
      • 20% at onset; 54% at any time
      • Kenalog in Orabase
    • SJOGREN’S SYNDROME
      • Sjogrens Syndrome; Primary and Secondary
      • Auto immune disease that effects the lacrimal and salivary glands
      • RA
      • SLE
    • Basic Mouth Anatomy
    • Sicca
    • Parotid Swelling
    • Sicca
      • Dental Care
      • Water
      • Saliva substitutes( glycerate polymer preparations)
      • Pilocarpine 5mg tid
      • Cevimilene 30mg tid
    • Infections/mouth
      • Candida
      • H. Simplex
    • Herpes simplex
    • Herpes Simplex
    • H. Simplex
      • Anti Viral,
        • Acyclovir,Valacylovir, Famciclovir
        • Topical: Acyclovir or Penciclovir
    • Oral Candida
      • Steroids
      • Sicca
      • Anti Fungal Agents
        • Oral Solutions
        • Systemic
    • Oral Candida
    • Bisphosphonates
      • Osteoporosis medications:
        • Alendronate, Risendroante and ibandroante
        • Zoledronic Acid
      • Effect Osteoclast activity
    • Osteonecrosis of the Jaw
      • Most common (rare) in cancer patients with frequent infusions of potent nitrogen containing bisphosphonates
      • Painful jaw pain, usually the mandible, with area of exposed bone.
      • Dental exam before starting therapy?