The Croatian Primary Sjögren's Disease Oral Health Study: Oral Status and Oral Health-Related Quality of Life

Ana Glavina; Ivona Božić; Katica Parat; Dijana Perković; Dolores Biočina-Lukenda; Dušanka Martinović Kaliterna; Mislav Radić

doi:10.3390/jcm12144804

The Croatian Primary Sjögren's Disease Oral Health Study: Oral Status and Oral Health-Related Quality of Life

J Clin Med. 2023 Jul 21;12(14):4804. doi: 10.3390/jcm12144804.

Authors

Ana Glavina^{1

2}, Ivona Božić³, Katica Parat¹, Dijana Perković^{3

4}, Dolores Biočina-Lukenda^{1

2}, Dušanka Martinović Kaliterna^{3

4}, Mislav Radić^{3

4}

Affiliations

¹ Dental Clinic Split, 21000 Split, Croatia.
² Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia.
³ Division of Rheumatology and Clinical Immunology, Center of Excellence for Systemic Sclerosis in Croatia, University Hospital Split, 21000 Split, Croatia.
⁴ School of Medicine, University of Split, 21000 Split, Croatia.

Abstract

To determine salivary flow rate, oral and periodontal status, oral health-related quality of life (OHRQoL), objective and subjective indexes, and serum antibody reactivity in patients with primary Sjögren's disease (pSD). Thirty-one patients with pSD and 31 control subjects participated in this cross-sectional, single-center study. The unstimulated whole salivary flow rate (UWSFR) and stimulated whole salivary flow rate (SWSFR), salivary pH, DMFT index (DMFT = D-decayed, M-missing, F-filled tooth), periodontal pocket depth (PPD), clinical attachment level (CAL), interincisal distance, OHRQoL, objective European League Against Rheumatism (EULAR) SS Disease Activity Index (ESSDAI) and subjective (EULAR SS Patient Reported Index (ESSPRI), 6-items-VAS-SS (Visual Analog Scale), Profile of Fatigue) indexes were analyzed. The patients with pSD had a blood sample taken in the morning between 7 and 10 a.m. for comprehensive laboratory analysis. Patients with pSD had statistically significant lower UWSFR (0.20 vs. 0.90 mL/min) and SWSFR (0.56 vs. 1.64 mL/min) values compared with control subjects (p < 0.001, Mann-Withney U test). Salivary pH value of pSD patients was significantly lower compared with control subjects (6.00 vs. 7.00; p < 0.001, Mann-Whitney U test). The mean DMFT index of patients with pSD compared to control subjects was not statistically significant (23.74 ± 7.28 vs. 20.77 ± 5.73; p = 0.08, t-test). Interincisal distance was significantly decreased in the pSD group compared with control subjects (43.80 ± 0.38 vs. 47.60 ± 0.50; p = 0.003, t-test). The prevalence of periodontitis was similar in patients with pSD and control subjects (83.9% vs. 77.4%; p = 0.35, λ² test). The mean Oral Health Impact Profile (OHIP-49) total score was statistically significantly higher in pSD patients compared with control subjects (32.00 vs. 8.00; p < 0.001, Mann-Whitney U test). Patients with pSD have decreased salivary flow and salivary pH, poor oral health, decreased interincisal distance, high prevalence of periodontitis, and worse OHRQoL. These findings highlight the need for a multidisciplinary approach to the management of patients with pSD that includes physical and psychological aspects of the disease.

Keywords: Sjögren’s syndrome; dental caries; oral health; periodontal diseases; quality of life; saliva.

Grants and funding

This research received no external funding.