AUTOIMMUNE DISEASES
When a patient tells me they have an autoimmune disease I know only the generalizations of the diseases. Ya it lowers the immune system. Ya,good homecare is needed. Ya, a low immune system makes it harder to fight infection, so flossing is very important to these patients. I hate to admit it but that’s the extent of knowledge I have with these diseases. When a patient discloses a certain name to it, there’s a chance I may know about it or I may not. I recognize a handful of the common ones but sometimes I’m obligated to ask the patient and then google it later. But later doesn’t help me in the now, in improving the patients in-office experience or at-home experience. So, I had to learn more.
Autoimmune diseases occur when the body’s immune system attacks healthy cells by mistake. Ideally the purpose of the immune system is to fight off and defend the body from invasion. But when the body starts to attack its own cells and tissues an autoimmune disease has occurred. With most body parts being affected there are no cures only symptom control and relief. These diseases tend to come and go with flare-ups. When patients mention in their chief concern, they had something going on in the mouth a month ago, but hasn’t had it since, it can be challenging to determine what it was. Especially if they are not honest in their health history or even know if they have an autoimmune disease.
While there are over 100 autoimmune diseases, I will cover the more common ones and their oral health symptoms and risk factors that pertain to dentistry. The commonality of autoimmune diseases tends to be an older age, women, genetics and Caucasians. The oral heath affect tends to be mouth sores, dry mouth, an increase in dental cavities and periodontal concerns.
This is just a short list with many more to explore: But hopefully this helps next time you experience a mouth issue that comes and goes. It’s a high chance it could be an autoimmune disease.
| Autoimmune disease | Description | Oral health | Risk factors |
| Celiac | Gluten allergy | Enamel defects, delayed dental development, canker sores, cavities, burning sensation of the tongue | Genetic, other autoimmune diseases, women, |
| Diabetes | Immune system attacks the cells that make insulin | Periodontal disease, gingivitis, dry mouth, mouth sores, angular cheilitis, slow healing, loss of taste | Genes, obesity, diet, smoking |
| Graves’ Disease (hyperthyroidism) | The Immune system attacks the thyroid and over- produces hormones | Enlarged or extra glandular thyroid tissue at the back of tongue or throat, rapid tooth growth in children, osteoporosis of the jaw, increase in cavities | Genes, stress, other autoimmune diseases, smoking, history of infections, pregnancy, women |
| Hashimoto’s Disease (hypothyroidism) | The immune system attacks the thyroid causing it to under-produce enough hormones | Facial and throat swelling, gum disease, macroglossia, slow healing of mouth sores, delayed tooth growth in children | Genes, stress can worsen the condition, diet, lack of iodine, medications, women, age |
| Inflammatory Bowel Disease | Inflammation of the entire digestive tract, includes Crohn’s disease and ulcerative colitis | Inflammation of the gums, mouth ulcers, lip swelling | Genes, age, smoking, diet high in fat or refined, NSAIDS |
| Lichen Planus | A chronic inflammatory mucocutaneous disease that commonly affects the oral cavity | White lacy patches, red tissue, swollen tissues, open sores |
Stress, dental fillings, oral habits medications: high blood pressure, diabetes, pain killers, malaria |
| Multiple Sclerosis | Immune system attacks the myelin and causes a lack of communication between the brain and the rest of the body | Dry mouth from medications, lack of muscle strength and dexterity cause poor hygiene and results from that | Genes, colder climates, smoking, white race, age, women, low Vit D This one is deadly. |
| Rheumatoid Arthritis | Attacks the joints | Gum disease, loss of motion in TMJ, oral infections, hand grip with brushing and flossing | Genes, age, women, smoking, lack of giving birth, obesity |
| Sjögren’s Syndrome | Immune attacks the moisture producing glands such as lacrimal and salivary | Dry mouth, dental caries | Lupus, rheumatoid arthritis, age, women |
| Systemic Lupus | Attacks its own tissues |
Painless red and white sores on the palate, lips, gums, cracked lips, dry mouth, Meds side effects: thrush, joint pain in the jaw, damage to mouth and jaw bones |
Genes, women, age, people of color |
