Sjögren’s Syndrome Rachel Alvernaz #1, Brittany Flavel #5, Christina Fraijo #6, Stacey Smith #17 DENHY-125 12/07/15

Background Sjögren’s syndrome is an autoimmune disease that attacks the mucous membranes and glands of the body. http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/sjogrens-syndrome.html Slide by: Stacey Smith #17

It can occur on its own but often will accompany another rheumatic disease (Rheumatic diseases affect joints, bones, muscles, skin and sometimes other organs). Such as: http://www.noahhealth.org/natural-ways-to-treat-arthritis/#kotran Slide by: Stacey Smith #17

Slide by: Stacey Smith #17 It mostly commonly effects the eyes and mouth causing xerostomia (dry mouth) as well as keratoconjunctivitis sicca (dry eyes) http://www.bio.davidson.edu/courses/immunology/Students/spring2000/baker/bioprotein/Restricted/sjogrens.htm http://www.examiner.com/article/sj-gren-s-syndrome-symptoms-diagnosis-and-treatment This causes the individual effected not only discomfort but many other issues such as: Increased risk of cavities due to lack of saliva to wash bacteria away from the teeth as well as difficulty speaking and eating. Sensitivity to light due to the damage keratoconjunctivitis sicca can cause. Slide by: Stacey Smith #17

Venus Williams is a Sjögren’s sufferer! Risk factors: The causes of Sjögren’s syndrome are not completely understood as is the case with many autoimmune diseases. There may be a genetic predisposition to the disease as well as a higher rate if you are a woman. Environmental factors involving viruses contracted previously by the patient may also cause the onset of the disease. http://www.sportsworldnews.com/articles/42480/20150703/2015-wimbledon-update-coach-says-he-thinks-venus-williams-can-win-championship-video.htm Slide by: Stacey Smith #17

Histology Mainly effects lacrimal and salivary glands Large amount of lymphocytes build up within effected glands Primary lymphocytes CD4 T cells B cells Memory cells Immune-globulin secreting plasma cells Immune response then acts on the body’ own glands Causes glands to become damaged Lose function Slide by: Christina Fraijo #6

Slide by: Christina Fraijo #6 Normal histology of a minor salivary gland without the large amounts of lymphatic cells Slide showing a large amount of Lymphocytic material building up in a salivary gland. http://www.ouhsc.edu/histology/text%20sections/upper%20gi.html http://www.cyberounds.com/cmecontent/art272.html?pf=yes Slide by: Christina Fraijo #6

Case Study Barbara McGregor, a 45 year old female, has complaints of a very dry mouth & itchy dry eyes. She also experiences pain from Rheumatoid Arthritis. She enjoys playing the bagpipes but hasn’t been able to recently due to her issues with xerostomia and arthritis. Slide by: Entire Group

Unmet Human Needs Skin & Mucous Membrane Integrity of the head & neck: Has dry mouth (xerostomia); difficulty swallowing & speaking; low salivary flow Has dry eyes (keratoconjunctivitis sicca) Responsibility for Oral Health Doesn’t brush as often as she should due to pain from rheumatoid arthritis, which is commonly linked to Sjögren’s Syndrome. Slide by: Brittany Flavel #5

Dental Hygienist Interventions Skin & Mucous Membrane Integrity of the head & neck: It is important to educate Barbara on possible treatments for xerostomia like chewing sugar free gum, not using mouthwash that contains alcohol that can dry out the mouth, over the counter saliva substitutes containing xylitol, like Mouth Kote or Oasis Moisturizing Mouth Spray, and possibly using a humidifier at night. https://cdn.shopify.com/s/files/1/0725/9041/files/biotene-dry-mouth-gum.jpg?1291258882 – Also educate her on the treatment for dry eyes. With keratoconjunctivitis sicca, eye drops may be used or surgery performed to plug the drainage of the tear ducts so that more tears that reach the eyes are able to remain there. Drugs that have shown to increase production of tears and saliva may be prescribed. http://www.parnellpharm.com/images/Parnell3.jpg Slide by: Rachel Alvernaz #1

Dental Hygienist Interventions Responsibility for Oral Health Since Barbara has Rheumatoid Arthritis and doesn’t feel comfortable brushing, it is the hygienists job to go over other arthritis friendly options for brushing like the DenTrust 3 sided toothbrush. http://shop.sensory-smart.com/ekmps/shops/sensorysmartuk/images/dentrust-3-sided-soft-toothbrush-for-sen-sensory-brushing-colour-yellow-[2]-4205-p.gif Slide by: Rachel Alvernaz #1

Sources Carr, Alan. “Dry Mouth.” Treatment: Tips for Controlling Dry Mouth. N.p., n.d. Web. 04 Dec. 2015. http://www.mayoclinic.org/diseases-conditions/dry-mouth/expert-answers/dry-mouth/faq-20058424 Mayo clinic staff (July 08, 2014). Diseases and conditions Sjögren’s Syndrome. Retrieved October 20, 2015, from http://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/basics/definition/con-20020275 Miller, Anne V. MD (September 25, 2015). Sjögren’s Syndrome. Retrieved October 20, 2015, from http://emedicine.medscape.com/article/332125-overview#a5 Wikipedia contributors (August 12, 2015). Sjögren’s Syndrome. Retrieved October 20, 2015, from https://en.wikipedia.org/wiki/Sj%C3%B6gren%27s_syndrome

Who is more likely to get Sjögren’s Syndrome? A. a 9 year old boy B. a 50 year old woman C. a 29 year old man

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Sjögren’s Syndrome: A. Can be complicated by infections of the eyes, breathing passages, and mouth B. Is an autoimmune disease C. Involves inflammation of glands and other tissues of the body D. All of the above

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What type of condition(s) is Sjögren’s Syndrome associated with? A. Systemic Lupus B. Rheumatoid Arthritis C. Scleroderma D. All of the above

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