Dental Care and Lupus

Oral lesions are common among lupus patients. What are they and how can we prevent and/or treat them? Read further for helpful information and tips on how to take care of your mouth.

Oral lesions and How To Treat Them

Taking care of your teeth is important whether or not you have a chronic condition. When you have an autoimmune disease such as lupus, it is vital that you take care of your mouth and teeth to guard against tooth decay, dry mouth, infections and loose teeth. Because lupus patients are susceptible to infections, it becomes even more important to brush and floss daily as well as visiting the dentist at least twice a year. Infections can cause serious setbacks and spread to other parts of the body. If not treated in a timely fashion, it could lead to a flare, hospitalization or even death. Even with proper brushing and flossing you can still experience some inflammation. Approximately 20-25% of Lupus patients with SLE experiences oral issues.

One of the most important things you should do is select a dentist that has experience with lupus patients. A better choice would be an oral pathologist if mouth involvement is severe. This is extremely important because many times lupus patients have to pre-medicate before a visit. Your dentist should examine your neck and head along with your mouth for inflammation or any other abnormalities. This is especially important if you wear glasses or have long hair because it is difficult for you to examine these areas yourself.

Selecting the right toothbrush is also important. Find one that is soft or extra soft, especially if you are prone to lupus lesions on your gums. You might also want to find one with a small or compact brush head so the toothbrush will fit easily in your mouth. This is also helpful if you have an arthritiic condition and have difficulty holding your toothbrush. If you have problems griping the brush, build it out with masking tape, a sponge curler or tubing.

Calcium depletion can cause bone loss which can wreck havoc on your teeth. If you don’t have enough calcium in your system your teeth become vulnerable and decay faster. Your teeth can also decalcify and turn portions of your teeth abnormally white, making color uneven. Calcium supplements can help guard against bone loss. A great way to test your calcium supplements efficiency is to drop a tablet into 6 ounces of white vinegar at room temperature. If the tablet does not dissolve in 30 minutes, chances are your body isn’t absorbing the calcium. Doctors suggest between 1600 and 1800 mg of calcium per day for people with calcium deficiencies. The problem is that your body can not aborsorb all of that in one sitting. The best thing to do is to get some of your calcium from foods or drinks. If that is difficult try breaking up calcium supplements into three increments.

Oral Inspections

Get to know yourself in and out and you will be able to sense when something isn’t quite right with your mouth and face. It is not uncommon to have ulcers of the mouth which usually start out as little red patches followed by bleeding and pain. As the ulceration heals it will leave a little impression. Inspect your mouth and lips regularly so that you have an idea of what “normal is”. If you see a something other than what you are used seeing then that could be the beginning of a lupus lesion. Inspect your face, look for lumps and swelling so that when changes occur you will notice them.

Lip lesions can be found with white plaque. This plaque is heavy, thick tissue and is fairly diagnostic. Other conditions such as syphilis, diptheria and yeast infections can produce this white plaque, the difference is with those conditions, the white plaque is wipeable. There is a very low accurance of malignancy with the lupus lesions

With the tongue you can get a bald tongue. Instead of bumps and ridges there will be a smooth soft area and it can lead to severe fissuring of the tongue. If food gets in the fissures, an ulceration can occur. Look for fissures and check the evenness on both sides. Look for small varicose veins. If you have liver or kidney problems you might see an increase of these veins. Do not overlook the sides of your mouth or the roof of your mouth.

You should also inspect your lymph nodes which are located on each side of the neck. The lymph nodes drain things from your neck and head. Touch both sides of this muscle by turning your head a little which will make the nodes stand out better. You shouldn’t feel any lumps or bumps and if you do, they should not be hard like a rock. If you feel pain that is okay because it means it is not malignant.

Tips

· Do not have any dental work done during a flare unless absolutely necessary.

· If you are on steroid therapy, take extra special care of your teeth and make sure to see a dentist at least twice a year, more often if you have mouth ulcers.

· If you have mouth ulcers, avoid toothpaste. Try baking soda instead.

· Because surgeries can cause a flare, dental surgery should be avoided unless absolutely necessary. This includes teeth extraction.

· Wearing dentures may irritate the sores and ulcers in the mouth. Do not wear adhesives and when using denture cleaners, rinse of thoroughly before inserting in mouth.