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Treatment of dry mouth and other non-ocular sicca symptoms in Sjögren's syndrome

Alan N Baer, MD, FACP
Section Editor
Robert Fox, MD, PhD
Deputy Editor
Paul L Romain, MD


Sjögren’s syndrome (SS) is a chronic multisystem inflammatory disorder characterized by lymphocytic infiltration of the lacrimal and salivary glands and resultant dry eyes and mouth. A variety of other disease manifestations may also be present, including additional issues related to exocrine gland dysfunction, such as dryness of the skin, nasal passages, and vagina; extraglandular involvement; and systemic symptoms, such as fever and malaise. Both local and systemic medical therapies are used in the treatment of the different manifestations of SS [1-4].

The treatment of dry mouth, including topical therapy; the use of systemic cholinergic agents and other systemic therapies; and other therapies for the management of other non-ocular sicca symptoms of SS will be reviewed here. Other issues in SS, including the clinical manifestations, the diagnosis, the treatment of dry eye, and the role of systemic therapy in extraglandular manifestations of SS, are discussed separately. (See "Clinical manifestations of Sjögren's syndrome: Exocrine gland disease" and "Clinical manifestations of Sjögren's syndrome: Extraglandular disease" and "Diagnosis and classification of Sjögren's syndrome" and "Treatment of dry eye in Sjögren's syndrome: General principles and initial therapy" and "Overview of the management and prognosis of Sjögren's syndrome".)


Overview of management — Treatment of dry mouth due to salivary gland hypofunction aims to alleviate symptoms and prevent complications such as dental caries, periodontal disease, halitosis, salivary gland calculi, dysphagia, and oral candidiasis. Various strategies are employed to compensate for the loss of normal salivary functions; these functions include lubricating the mucosa, helping to clear food residue that may lead to dental plaque and bacterial growth, buffering acids that favor demineralization of teeth, and providing antimicrobial effects [1].

Thus, stimulation of existing salivary flow and replacement of salivary secretions, along with close attention to dental care, are major aspects of treatment [1,3,5,6]. Our treatment approach is consistent with expert opinion and is supported by the evidence reviewed here [6,7]. Briefly, this approach includes the following:

Basic self-care measures to stimulate oral secretions and prevent oral dryness and dental caries, as well as regular preventive dental care. (See 'Basic measures for all patients' below.)

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Literature review current through: Sep 2017. | This topic last updated: Jan 06, 2017.
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