Reumatoid artrit, Sjögrens syndrom och karies

English summary Rheumatoid arthritis, Sjögrens syndrome and dental caries Nor Tannlegeforen Tid. 2021; 131: 1120-30. The autoimmune diseases rheumatoid arthritis (RA) and Sjögren’s syndrome (SS) have a negative effect on the mouth with hyposalivation and an increased risk of caries as a result for all SS patients and also for many RA patients due to secondary SS. In addition, modern RA medication causes immunosuppression with increased risk of infection, and combined with pain and impaired function in the hands and fingers, it entails an increased risk of caries. Scientific studies show that patients with RA and SS have more carious and extracted teeth, often not regular dental appointments and high dental costs. It is therefore of the utmost importance that the rheumatologist early in the patient’s diagnosis refers the patient to his/her regular dental clinic or to a Specialist Clinic in Oral Medicine in order for the patient to maintain good oral health. The task of dental care is to make an accurate caries risk assessment with emphasis on self-perceived dry mouth xerostomia and an objective assessment of hyposalivation through clinical inspection and saliva sampling where the volume of resting saliva is of greatest interest. Caries prevention is based on the results of the caries risk assessment, with emphasis on good self-care with fluoride, diet and oral hygiene and regular visits to dental care. Fluoride toothpaste and fluoride solution are the important daily fluoride protection that should be supplemented with other fluoride products, such as high fluoride toothpaste, fluoride gel, fluoride tablets and fluoride chewing gum. For oral hygiene, there are various aids that facilitate tooth cleaning in case of impaired hand function. Saliva-stimulating and moisturizing products available in a wide range are important complements to conventional caries prevention when there is a marked reduction or lack of salivary gland tissue. The patient should be called to the dental care every 6 or alternatively every 3 months for control of self-care and for fluoride varnish application.