The Oral Care Connection
The mouth is a hotbed of activity for bacteria, many of which can cause problems to a persons overall health. In our mouths we have 500 different types of bacteria, at least 11 of which can cause periodontal disease, says Daniel Klein, D.D.S., a dentist in Arizona. Lupus is tied to a variety of oral health concerns. But lupus only starts the problem. It can be elevated highly because of poor oral hygiene.
Periodontal diseasemore commonly known as gum diseaseis of particular concern because of the link between inflammation of the gum area and the overall health of the rest of the body. Recent scientific literature suggests a strong relationship between oral disease and other systemic diseases and medical conditions, Klein says. It is imperative that patients understand periodontal disease and how it is treated or prevented.
There is strong evidence for a link between lupus and poor oral and dental health. Recently, a 2019 study highlighted the need for lupus patients to have increased dental management due to the high risk of periodontal disease and temporomandibular joint disorders.
How Lupus Affects Your Mouth
The most common mouth problem caused by lupus is the oral ulcer. Oral ulcers appear as whitish plaques and ulcerations that are not painful thats why your dentist may be the first doctor to notice them.
Other problems may arise if lupus is associated with another autoimmune condition called Sjogren’s syndrome. In this case, you will have less saliva and tears and thus the mouth and eyes will be extremely dry.
Saliva plays an important role in oral health and when you dont have enough, you may be likely to catch an infection as well as troubles speaking or swallowing. Although some lupus patients report frequent dental cavities and tooth decay, there is no data linking lupus directly with these issues.
Lupus Mouth Ulcers/Lesions
Mouth sores or lesions may or not be painful, but you should let your rheumatologist or dentist know about them when they flare up. Lesions are an indication that the disease is in an active state, and the oral symptoms are a legitimate warning sign that you should take note of.
If the lesions are painful, a homemade “miracle mouthwash” can offer temporary relief. Mix together one part liquid Benadryl and one part milk of magnesia. Rinse thoroughly or dab the mixture directly onto the sore, but do not swallow the mouthwash.
Taking Lupus Medications As Recommended
It is quite important to understand that medications cannot cure lupus. They can only control lupus symptoms as well as prevent or slow down organ damage. Moreover, lupus treatment usually depends on your signs and symptoms. You can discuss with your doctor regarding the risks and benefits of lupus medications.
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The Impact Of Lupus On Oral And Dental Health
From ulcers and dry-mouth, to tooth decay and gum disease, lupus can significantly affect your oral and dental health. Read more about the surprisingly complex relationship between lupus and a healthy smile!
The mouth can be a window into overall health. When an individual has a chronic illness such as SLE, keeping on top of oral health is just as important as keeping the rest of the body healthy. Without a proper diet, self-care and medical dental intervention, overall health may become vulnerable and weaken when under the attack of microscopic bacteria or other conditions. Individuals with lupus should pay strict attention to any new symptoms or changes in health including oral and dental health.
Signs and Symptoms of Oral and Dental Health Issues in Lupus
Up to 40% of individuals with SLE may develop various mouth ulcers including desquamative gingivitis , marginal gingivitis and erosive mucosa lesions . Common signs and symptoms of compromised oral and dental health include:
- gums that are red, tender, bleeding and swollen, or pulling away from teeth
- gum infections
- inflammation of the tongue, and
- lesions and ulcers in the mouth and/or on the gums
Causes of Oral and Dental Health Issues in Lupus
Some medications, including some of the drugs used to treat lupus, may cause mouth ulcers. These treatments include immunosuppressants, corticosteroids, and anti-rheumatics such as methotrexate.
Other medications that may cause mouth ulcers include:
Maintaining Good Oral Hygiene
Oral hygiene is very important to avoid any type of oral problems. Use a soft bristle toothbrush while brushing and avoid getting in contact with the affected area to prevent injury. You can also schedule an appointment with your dentist to better understand the importance of oral health after being diagnosed with lupus.
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Lupus Mouth Sores And Gum Disease
Our dentists recommend frequent sips of water, specially formulated sugar-free lozenges, and lubricating oral rinses. Dry mouth, whatever the cause, puts you at risk of both dental decay and gum disease. If you think you have a dry mouth, tell your dentist. They can examine your saliva and the glands and work with your physician to help diagnose and manage the condition, whatever the cause.
Periodontal Disease. People with lupus are more likely to suffer from periodontal disease than most. Periodontal disease occurs when the bacteria in the mouth change from being relatively healthy and friendly to infectious and unfriendlyharmful bacteria and waste products damage tissues around your teeth. Ultimately, damaged tissue is affected by the bacteria and lupus itself. Common symptoms of periodontal disease are red, inflamed, bleeding gums, possibly lousy breath, and in the advanced form of the disease, the gums recede, making the teeth look longer. If you have gums that bleed, it is a sign you need to see a dental professional.
What Causes Oral And Nasal Sores In People With Lupus
Lupus ulcers are usually red with a white halo. Oral ulcers most often appear on the roof of the mouth, inside the cheeks, or on the lips. Nasal ulcers usually appear on the septum or on the thick central cartilage of the nose.
These mouth and nose sores may be a direct symptom of lupus, its treatment, or related conditions. In some cases, mouth sores may be unrelated to lupus and caused by factors such as stress, hormonal changes, or a nutritional deficiency.
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What Is The Onset Of Lupus Mouth Sores Like
It is common knowledge that many people with lupus start developing skin problems of many sorts. As mentioned above, some of these include lupus mouth sores, which could be either painful or entirely painless. The painless subtype of mouth sores is white with a red outline, which appears to be a raised bump. However, the other subtype of lupus mouth sores is painful, which appears red and is surrounded by white lines.
Research undertaken on SLE patients has concluded that these mouth sores symptoms of lupus feel like regular mouth ulcers, the type you are likely to get after accidentally biting the inside of your cheek or by biting the inner skin of your lips in dry weather. Their texture often feels like the roof of your mouth after burning it by eating or drinking something hot.
The Awful Sores In Her Mouth Were A Symptom Of Something Very Serious
Elizabeth Starrels sat in the examining chair of a Washington ear, nose and throat specialist in October 2012, weeping in frustration and pain.
For the previous four months, Starrels, then 52, had been battling painful mouth sores that were getting worse. Eating had become a near impossibility, and Starrels, who was largely subsisting on smoothies, had lost 20 pounds.
Her dentist and an oral surgeon told her she had thrush, a yeast infection caused by an overgrowth of fungi in the mouth that can result from antibiotics. The rinses and medicines they prescribed worked only briefly or not at all.
The ENT whom she saw next disagreed. He suspected that her problem was an inflammatory disease. When Starrels, a registered nurse who works at MedStars Georgetown University Hospital, broke down, telling the doctor she didnt think she could live with the pain, his response was brusque.
He told me I would have to learn to live with it I had no choice, she recalls. The doctor offered to prescribe an antidepressant.
Starrels said that the ENTs reaction had a galvanizing effect: She didnt need an antidepressant, but she did need someone who seemed interested and willing to help her. As a nurse, she said, I could advocate for other people but not for myself.
Two months and several additional doctors later, Starrels received a new diagnosis as well as effective treatment. She also found encouragement online, through a support group whose help she considers invaluable.
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Can Lupus Be Prevented Or Avoided
You cannot avoid lupus since the cause of it is unknown. However, you may be able to help prevent flares. Common triggers include:
If you take medicines to help manage lupus, do not stop taking them without your doctors approval. This can cause flares as well.
Knowing the things that cause flares can help you better cope with your symptoms.
Mouth And Nose Sores In Lupus: Causes And Treatments
Mouth sores and nose sores, sometimes called ulcers, are common symptoms of lupus. Mouth and nose sores may be a first sign of the disease and may help lead to an initial diagnosis. Oral and nasal ulcers are also a common sign of lupus flares periods when the disease is active and the symptoms are worse or more noticeable than usual. In fact, studies suggest that people with lupus are at greater risk of these ulcers the longer they have had lupus and if they have oral hygiene problems.
Lupus-related ulcers in the mouth can feel similar to canker sores. Mouth and nose sores can range from uncomfortable to unbearably painful, especially if theyre not treated. I can barely talk. Even drinking water is painful, shared one MyLupusTeam member about their mouth sores.
Heres what to know about why these sores form and what you can do to find relief.
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The Many Faces Of Lupus
Although lupus appears in different ways, some unlikely symptoms seem to be more commonplace than others. One of the more frequent complaints is cognitive dysfunction, or lupus fog.
I went to a neurologist because my cognitive abilities were diminishing by leaps and bounds, says Judy Terrean of Newport Beach, CA. Terrean was diagnosed with lupus cerebritis five years ago.
I used to work in real estate selling new tract homes. But it came to the point where I couldnt figure out purchase agreement terms or loan amounts. Paperwork would trigger panic attacks. That part of my brain just wasnt working, she says.
Cognitive dysfunction, such as memory loss or forgetting names, occurs in a significant number of people with lupus, even when the lupus isnt active, confirms Murray B. Urowitz, MD, director of the Centre for Prognosis Studies in the Rheumatic Diseases in Toronto.
Urowitz points out that the problem can be triggered by several things. Whats the mechanism? Its tricky. One possibility is there has been inflammation of the brain during active lupus, which may leave a person a little deficient in this area.
Another lupus symptom may be a loss of balance. Right before I was diagnosed, I started having equilibrium problems, says Paul Rosenthal, 58, a physical therapist from Ashland, OR.
I fell crossing the street one day, fell in my garage, and fell at work, putting a big gash in my arm and ending up in the emergency room, he recalls.
How Are Mouth Ulcers Treated
Most of the time, mouth ulcers heal on their own without treatment within a week. You can relieve any discomfort with a numbing anaesthetic mouth gel applied to the area, which you can buy over-the-counter from pharmacies.
If you are experiencing a lot of pain from your mouth ulcers, ask your doctor about other pain relief options.
The healthdirect Service Finder tool can help you find doctors, pharmacies, hospitals and other health services.
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Keep An Eye Out For Side Effects
Remember that any medicine you take for lupus can have side effects. Talk with your doctors about what changes to watch for with the medicines youre taking. And tell your treatment team right away if you have any side effects.
If you have symptoms of digestive problems, tell your doctors right away. Its important to treat these problems early, before they cause serious damage to the digestive organs.
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How Is Lupus Diagnosed
Lupus is a disease that is known for being difficult to diagnose. The symptoms are different from person to person. Sometimes, the symptoms may mimic those of another disease. Often, lupus symptoms come and go. It can sometimes take several years to receive an official diagnosis.
Getting an early, accurate lupus diagnosis can reduce its long-term effects.
There is not just one test doctors can use to tell if you have lupus. Doctors must consider many different sources of information. Your doctor will look at:
- Results from lab tests .
Your doctor may also order blood and urine tests, such as:
- Antinuclear antibody test. This test checks for antibodies to the nucleus of your cells. A positive result means that your immune system may be attacking healthy cells. This does not always mean that you have lupus. Your doctor may recommend you see a specialist for more testing.
- Complete blood count. Lupus often affects a persons red blood cell, white blood cell, and platelet count. This test checks for anemia or the presence of certain proteins in your blood.
- Erythrocyte sedimentation rate and C-reactive protein tests. Results from these tests will show if there is inflammation in your body.
- Urinalysis. Extra protein in the urine may show up in a lab test if lupus affects your kidneys.
Depending on your symptoms and test results, your doctor also may order a skin or kidney biopsy.
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Mouth And Nose Ulcers Causes
These sores may appear during lupus flares, along with joint pain, rashes on other parts of the body, and hair loss. In some people, stress or being overly tired may make mouth ulcers worse. In others, mouth ulcers are a signal that a flare is coming.
These sores may be triggered during a severe flare, the hormonal changes of pregnancy, when you are low on vitamin B12 or iron, or when you take NSAIDs or beta-blockers. The good news is that mouth ulcers tend to go away when the flare subsides.1-3
When To See Your Pharmacist Dentist Or Gp
Mouth ulcers can be painful. They can make it uncomfortable to eat, drink or brush your teeth.
It’s usually safe to treat mouth ulcers at home. You can buy several types of mouth ulcer treatment from a pharmacy.
Speak to your pharmacist about the best treatment for you or your child.
See your GP or dentist if:
- your mouth ulcer has lasted three weeks
- you keep getting mouth ulcers
- your mouth ulcer becomes more painful or red this could be a sign of a bacterial infection, which may need treatment with antibiotics
Mouth ulcers are also a possible symptom of a viral infection that mainly affects young children, called hand, foot and mouth disease.
Speak to your GP or call GP out of hours service if you’re unsure.
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What Can I Do To Look After Myself If I Have A Mouth Ulcer
Here are some tips to look after yourself when you have a mouth ulcer:
- Try not to touch the sore area. Touching can disturb the healing process and can also spread an infection. If you do need to touch the area, make sure to wash your hands before and after.
- Use a soft toothbrush to clean your teeth. If your sores are so painful that you canât brush your teeth, use a mouthwash containing chlorhexidine instead. This is available from most local pharmacies and some supermarkets. Avoid using mouthwashes that contain alcohol.
- Rinsing with salt water can help relieve pain and reduce the chance of infection. Make a saltwater rinse by mixing one teaspoon of salt into a cup of water. Take a mouthful of the liquid and hold it in your mouth so it covers the affected area for two minutes, then spit it out. Do not swallow it. Repeat this process 4 times a day.
- Eat soft foods.
- Avoid very hot or spicy foods and drinks. Drinking cool water can help to ease a painful mouth.
- If your mouth is very sore, try drinking through a straw.
What Do Autoimmune Mouth Sores Look Like
Oral lichen planus may appear as white, lacy patches red, swollen tissues or open sores. These lesions may cause burning, pain or other discomfort.
What autoimmune disease causes sores in mouth?
Behcets disease, also called Behcets syndrome, is a rare disorder that causes blood vessel inflammation throughout your body. The disease can lead to numerous signs and symptoms that can seem unrelated at first. They can include mouth sores, eye inflammation, skin rashes and lesions, and genital sores.
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Oral Lichenoid Contact Lesions
An oral lichenoid contact lesion is a white patch or plague at the buccal mucosa, and its appearance is similar to oral DLE and OLP . The cause of OLCLs is thought to be a delayed-typed hypersensitivity reaction to a component of dental restorative materials, and use of metallic dental fillings can induce this lesion. OLCLs usually disappear when the metallic dental fillings have been removed .
Lupus Treatment Or Other Medication
Some medications commonly used to treat lupus include antimalarial drugs, corticosteroids, immunosuppressants, and nonsteroidal anti-inflammatory drugs. Almost all classes of lupus drugs have mouth ulcers as a potential side effect. In particular, its been shown that daily use of corticosteroids can cause mouth and nose sores.
Certain other medications, like beta blockers and nicorandil, can also cause oral issues.
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