Oral and Dental Health in Systemic Sclerosis: Is it a Window to Other Systemic Affections?

Abstract

Background: Oral and periodontal manifestations are common in systemic sclerosis (SSc) which may result in poor nutritional status and significant morbidity. Better understanding of these manifestations is crucial for better patient outcomes. We aimed to evaluate dental and oral manifestations in patients with SSc in comparison to healthy control and to study the relationship between these findings and systemic sclerosis disease activity index, skin thickness, other systemic affection, as well as the oral health-related quality of life in these patients Patients and Methods: 50 patients with SSc were included in this case-control study (Group A) and 50 apparently healthy controls (Group B). The assessment included; a modified Rodnan skin score (mRss) and revised EUSTAR activity index measurements, and OHIP-5. The dental and oral assessment included: probing pocket depth (PPD), clinical attachment level (CAL), gingival recession height measurement (GH), gingival Index (GI), mobility Index (MI), Plaque Index (PI), the DMF index, bleeding on probing (BOP), dry mouth, and interincisal distance (ID) measurement. Result: In Group A the dental and oral findings were statistically significantly higher in comparison to Group B, except for the interincisal distance which was reduced in Group A. There was a negative correlation between ID and mRss and a positive correlation between CAL, BOP, and mRss. Dental parameters (PPD, CAL, GH, GI, PI, DMF, BOP) correlated positively with the revised EUSTAR activity index while ID correlated negatively. ID correlated negatively with GIT disorders and ILD, while Fibrosis of the buccal mucosa or the tongue, PPD, CAL, GH, GI, and DMF correlated positively. A positive correlation was found between OHIP 5 and each of; PPD, CAL, GH, GI, DMF, fibrosis of buccal mucosa or tongue, and negatively with ID. Conclusion: The incidence of oral and periodontal manifestations were higher in patients with SSc in comparison to controls. An association was found between different oral and dental findings and disease activity index, skin thickness, and oral health impact profile.