Dealing With Lupus Mouth Ulcers and Oral Health
When we think about lupus, we typically think arthritis – with pain, swelling and limited mobility of the joints. However, this condition can affect the entire body. Up to 40 percent of people with lupus will experience oral manifestations of the disease, like lupus mouth sores or lesions and dry mouth, among others.
The drugs used to treat lupus can also cause various side effects. You may find yourself booking more appointments to the dentist and wonder — does lupus affect your oral health and teeth?
How Lupus Affects Your Mouth
The most common mouth problem caused by lupus is the oral ulcer. Oral ulcers appear as whitish plaques and ulcerations that are not painful — that’s why your dentist may be the first doctor to notice them.
Other problems may arise if lupus is associated with another autoimmune condition called Sjogren's syndrome. In this case, you will have less saliva and tears and thus the mouth and eyes will be extremely dry.
Saliva plays an important role in oral health and when you don’t have enough, you may be likely to catch an infection (cavities, gum infections, fungal infections) as well as troubles speaking or swallowing. Although some lupus patients report frequent dental cavities and tooth decay, there is no data linking lupus directly with these issues.
Lupus Mouth Ulcers/Lesions
Mouth sores or lesions may or not be painful, but you should let your rheumatologist or dentist know about them when they flare up. Lesions are an indication that the disease is in an active state, and the oral symptoms are a legitimate warning sign that you should take note of.
If the lesions are painful, a homemade "miracle mouthwash" can offer temporary relief. Mix together one part liquid Benadryl and one part milk of magnesia. Rinse thoroughly or dab the mixture directly onto the sore, but do not swallow the mouthwash.
You may also experience a burning mouth, with or without the presence of open lesions, and the mouthwash can help with this as well. Don't use any types of mouth rinses that contain alcohol, as this will cause the mouth to sting further or dry out.
Xerostomia (dry mouth) is a common symptom associated with lupus, either from the disease itself or from medications taken to control it. Dry mouth not only makes it uncomfortable to eat or talk, it also predisposes you to tooth decay and gum disease. Your teeth require saliva for lubrication, so you want to do the best you can to keep your mouth lubricated.
Certain types of rinses have been formulated for dry mouth, but many people complain that they leave their mouths feeling slimy. Drink water often throughout the day, especially between meals. Chewing gum that contains the ingredient Xylitol will help keep teeth free of bacteria, and adding a supplemental fluoride (prescription or over the counter) to your daily routine will keep enamel strong.
Some people develop something called "leukoplakia" inside of their mouths. This is a white-colored, spiderweb appearance on the inside of the cheeks or sides of the tongue. It's important to have your dentist conduct an oral cancer examination at every check-up to identify precancerous or abnormal tissues in their earliest state. While many leukoplakias cause no problem whatsoever, others may be linked with oral cancers.
If you take cyclosporine, you may also notice a swelling or growth of hard, fibrous tissues along your gum lines. This is referred to as gingival hyperplasia. Most of the time it is purely an aesthetic concern, but if proper home care does not take place, it can offer additional surface area for bacteria to grow and form gum disease.
Make Sure Your Dentist and Doctor Communicate
Before you receive any type of dental care, your medical provider will need to communicate with your dentist about the state of your condition, and any precautions that need to take place.
Depending on your current health status, it may be necessary to be pre-medicated with an antibiotic before you are seen by the dentist for care. Some patients experience a higher risk of bleeding, making procedures such as extractions or other typically minor surgeries more complicated.
How Medication Can Affect Your Mouth
Many medications prescribed for lupus can affect your mouth. For example, steroid drugs suppress your immune system and can increase the risk of various infections (especially with fungi). Hydroxychloroquine and methotrexate can cause side effects such as mouth sores and lupus mouth ulcers. Overall, hundreds of drugs (not just used for lupus management) can cause dry mouth.
Help for lupus sufferers is available. Besides working with your dentist to improve your oral health, don’t forget to have regular follow-ups with your lupus specialist. The better lupus is controlled, the less chances you’ll have to get symptoms, affecting your mouth or the whole body.