This document discusses oral health issues related to lupus and Sjogren's syndrome. It outlines that oral ulcers, dry mouth, and infections are common oral manifestations. Medications used to treat lupus and Sjogren's can also impact oral health. Proper dental care, saliva substitutes, and medications like pilocarpine or cevimelene can help manage dry mouth. Fungal infections like candida and viral infections like herpes simplex need to be treated with anti-fungal or anti-viral medications. Bisphosphonates used for osteoporosis can potentially cause osteonecrosis of the jaw, so dental exams are recommended before starting these therapies.

1. Lupus and the Mouth Stuart A . Green MD Chief of Rheumatology

2. ACR Criteria

3. Acr criteria

4. SLE Oral Ulcers Dry Mouth (Sicca) Infections Medications

5. Oral Ulcers Hard Palate; tongue and buccal mucosa Painless typically, but can be painful 20% at onset; 54% at any time Kenalog in Orabase

6. SJOGREN’S SYNDROME Sjogrens Syndrome; Primary and Secondary Auto immune disease that effects the lacrimal and salivary glands RA SLE

7. Basic Mouth Anatomy

8. Sicca

9. Parotid Swelling

10. Sicca Dental Care Water Saliva substitutes( glycerate polymer preparations) Pilocarpine 5mg tid Cevimilene 30mg tid

11. Infections/mouth Candida H. Simplex

12. Herpes simplex

13. Herpes Simplex

14. H. Simplex Anti Viral, Acyclovir,Valacylovir, Famciclovir Topical: Acyclovir or Penciclovir

15. Oral Candida Steroids Sicca Anti Fungal Agents Oral Solutions Systemic

16. Oral Candida

17. Bisphosphonates Osteoporosis medications: Alendronate, Risendroante and ibandroante Zoledronic Acid Effect Osteoclast activity

18. 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?