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teeth and sclero


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#1 Margaret

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Posted 06 December 2009 - 07:38 AM

Hi, Everyone,

I just cruised through the dental section and was looking for some article that would explain teeth chipping away. Gareth came to me today and told me to call the dentist (right now!!!) because his 'tooth was sharp.' I looked at his bottom teeth and they are all chipped along the top --- he said "they were a saw." He's so limited on what he will eat and what goes into his mouth that I can't figure out how they got that way. Tomorrow, I will have to call the dentist to see if he can file them level, like we use to do with our ponies!!!

Take care, Everyone.
Margaret

#2 Peggy

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Posted 06 December 2009 - 08:20 AM

When I was at my last dental check my dentist is very aware of my having Sjogren's. Because of the Sjogren's he said it is very hard on teeth and that they can become decayed and that they also can do what is happening with Gareth's. I don't remember if Gareth has Sjogren's or not. If he does then it would explain why this is happening.

I'm so sorry that he has now another dilemma with this disease to fight. I hope you get some answers and please let us know what you find.

Warm hugs,
Peggy

#3 relicmom1

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Posted 06 December 2009 - 08:54 AM

Hey Margaret,

My teeth literally dissolved . They would crumble. My dentist said it was due to the excessive dry mouth and sclero. I eventually had to have them all removed and got denturesPosted Image . There are mouthwashes, etc to help with the dry mouth. Personally, I don't find them to be very helpful, it wouldn't hurt to give them a try. I am sorry this has started happening . My dentist also recommended a specific brand of mouthwash. If you want, PM me and I will give you the name. Good luck.

Peace :)
Barbara aka relicmom1

#4 warmheart

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Posted 06 December 2009 - 01:37 PM

Hi Margaret,

Sorry to hear about poor Gareth's teeth. Poor kid!

This is a sensitive area for me too (sorry, bad pun--couldn't resist!). Seven or eight years ago I suddenly started to feel like a pair of buckteeth with a face and body attached. Cluelessly, I figured my teeth had shifted and I needed braces, which I couldn't afford. So I kept trying to push my two front teeth back with my fingers to where they belonged. And I managed to break off the bottoms, which my dentist had to try to reconstruct with bonding. He tried to tell me I didn't need braces. A few years later he noticed that my skin had loosened quite a bit and it wasn't as hard to get my mouth open to work on my teeth. I had no idea until then that the problem wasn't my teeth, it was my lips that got too tight over them. Live and learn.

I'm very sure I don't have Sjogren's. If anything I have too much saliva, I guess from the paralyzed esophagus. But a lot of enamel erosion, which must be from reflux.

Hugs,

warmheart

#5 Margaret

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Posted 06 December 2009 - 02:27 PM

Hi,

Thank you for the responses. Now I have something to go on when I call the dentist. Last February, his eye doctor told me his eyes seemed awful dry, but Sjogren's was never mentioned. He's never been *officially* diagnosed with Sjogren's. Is there a blood test for that? I will have to check on it.

Thanks again and I will keep you posted.

Take care, Everyone.
Margaret

#6 Stacey

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Posted 06 December 2009 - 03:14 PM

Both of my grandmothers have Sclero and have both had to have their teeth pulled. I'm not sure if it's related to the Sclero or not. I'll have to ask.

#7 miocean

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Posted 06 December 2009 - 03:38 PM

I chipped a front tooth a couple of months ago and had to have it bonded. I have no idea how I chipped it. My mouth is extremely dry but I am also on fluid restriction for kidney failure. I have heard about lip biopsies to diagnose Sjogrens. What is the definitive test? My eyes are really dry and I had to stop wearing contact lenses but every once in a while they tear. It is very frustrating.
ISN Artist

#8 Margaret

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Posted 07 December 2009 - 01:54 AM

<<What is the definitive test? My eyes are really dry>>

Hi Miocean,

I know that the eye doctor can use some sort of paper to see how wet it gets -- I forget the name of the test, though. I did more reading last night and there are 2 blood tests for Sjogren's. I never knew it could affect the teeth, though. When first diagnosed, he had 3 white areas in his lower gum that the doctor thought were calcium deposits but they eventually went away and no real sores. I will keep you all posted after the dental visit. Thanks for all your input. It helps a lot!!!

Take care, Everyone.
Margaret

#9 Sweet

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Posted 07 December 2009 - 06:22 AM

Hi Margaret,

I'm sorry to hear about Gareths new problem with his teeth. Sjogrens is a likely culprit. There are several tests they can do for this. A couple are a Schirmer test, and also they can do a lip biopsy. Please let us know what the doctor ends up doing.
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)

#10 Margaret

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Posted 07 December 2009 - 09:29 AM

<<they can do a lip biopsy.>>

Sweet.....OUCH....is that done in the dental office? Why the lip...what happens to the lips in Sjogren's? I thought the disappearing lips were a sclero thing.

Take care, Everyone.
Margaret

#11 Shelley Ensz

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Posted 08 December 2009 - 12:38 PM

Hi Margaret,

I believe our wonderful Sweet is referring to a lip biopsy for Sjogren's (not for scleroderma, of course). I've had that, and it did help with the Sjogren's diagnosis (but it is not a be-all and end-all, other tests, such as Schirmer's plus medical history also go into the mix for diagnosis).

They go inside the front of the bottom lip (if you pull your lip down, right there, before you get to the gums and the teeth). It is not entirely pleasant, it took mine about a week to heal, and I don't think Gareth would much care for it. It is invasive, and in many cases it may not even be entirely necessary, either. I mean, I had a bone dry mouth that had already caused a lot of dental problems and even had several hospitalizations for parotid gland problems. So, anyway, after the biopsy and diagnosis, I still had a bone dry mouth and many dental problems (and we're not even discussing eyes, nose, and other more intimate problems).

A lip biopsy is just done in a doctor's office, under local anesthesia. It only takes a few minutes for the procedure, but it does involve local anesthetic (be sure it does not contain epinephrine, as that causes Raynaud's attacks) and stitches. And you know how the mouth is, the slightest little bump can feel like a mountain and it is hard to get your tongue to stay away from trouble zones, like stitches.

Anyway, I think what Sweet is getting at is that Sjogren's is what might be causing mouth dryness and that can be the cause of some dental problems. About 20% of people who have scleroderma also have Sjogren's, but you can also have Sjogren's all by itself (and it can also go systemic, not just attacking the moisture glands.) And, many people just plain have dry mouth, or have dental problems not caused by dry mouth.
Warm Hugs,

Shelley Ensz
Founder and President
International Scleroderma Network (ISN)
Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#12 Deb1million

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Posted 08 December 2009 - 01:04 PM

Thank you Shelley for the information. I have systemic sclero and Sjogren's. The Sjogrens was diagnosed by my opthalmologist with a Schirmmer's test and my medical history. He said I also have slight damage to the surface of my corneas from the extreme dryness, and I can't wear my contact lenses anymore. I also have a dry mouth and dental problems associated with this such as brittle teeth.

What I would like to know is - why would anyone decide to have a lip biopsy when the simple treatment is the same with or without the biopsy, ie: eye drops (prescribed by my opthalmologist) or synthetic saliva sprays, lozenges etc. What is the advantage of undergoing a painful test when the treatment would be the same? I admit I haven't read anything about it since my diagnosis, and don't know what systemic Sjogren's is either?

Thanks very much,

Debbie

#13 Sweet

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Posted 08 December 2009 - 04:23 PM

Thanks Shelley for the clarification. Yes that is exactly what I was talking about. :)
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)

#14 Shelley Ensz

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Posted 09 December 2009 - 10:13 AM

Hi Debbie,

You ask a good question about the lip biopsy. In my case, I had symptoms of many autoimmune diseases at once (as it turned out, I have Multiple Autoimmune Syndrome) and they really had to sort out whether Sjogren's was part of it, or not, for sure. But if it had been any less of a confusing situation, if I only had symptoms that could have been entirely accounted for by Sjogren's, then I really would have questioned it.

The doctor's consider it a "gold standard" for biopsy. Well, "gold standards" are very nice for things like enrollment in clinical trials and such but we do have a right to question whether they are truly necessary for individual diagnosis and care. So a great question to ask any doctor who wants to do a lip biopsy for Sjogren's is, whether the lip biopsy would in any way whatsoever change how they propose to treat your symptoms?

In my case, the biopsy results did change my treatment (I was put on plaquenil, then), and it also helped separate out some of my symptoms so that other things could more easily be diagnosed; and it ended up as one of the puzzle pieces for diagnosis of scleroderma, as well.

BUT this all still left me with a bone dry mouth and the treatment for a bone dry mouth wouldn't have been any different whether I had Sjogren's confirmed by biopsy, or not. I think. The plaquenil did not help that but rather a few of my systemic symptoms, such as fatigue and joint pain. Until I had to go off of it when I was also diagnosed with psoriasis, which can be made worse by plaquenil.)

But keep in mind I have tons of bad ideas (I could go in business selling them, if anyone would buy them!) and in general, I'm not a good example to follow for any sort of medical care ideas. Still, that's my opinion. So there.
Warm Hugs,

Shelley Ensz
Founder and President
International Scleroderma Network (ISN)
Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#15 Deb1million

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Posted 09 December 2009 - 11:28 AM

Thanks again Shelley

I was already on Plaquenil at the time my Sjogrens was diagnosed, so thats probably why they didn't want to do a lip biopsy (lucky me!)
Like you, I may also have Multiple Autoimmune Syndrome, as I have 8 so far!

I was interested to read that you had to stop Plaquenil due to Psoriasis, as I have noticed I have a new lesion on my leg that looks just like the one on my elderly neighbours arm, and he has psoriasis. (I'm his caregiver) I know it's not contagious so I wasn't concerned, but now it could be linked to the Plaquenil, I won't be happy if I have to stop taking it as I've felt better this year since I've been on it and Cellcept. I'd rather suffer a bit of psoriasis and not have the total fatigue and siezed joints I had last year. Maybe I won't mention it when I go to the doctor on 18th. I dont need autoimmune Number Nine!

Best wishes and warm hugs to everyone

#16 Margaret

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Posted 11 December 2009 - 02:55 PM

Hi Everyone,

I had Gareth to the dentist today and he filed the teeth down. He said he had decreased saliva but his glove didn't stick to his gums/cheeks like someone with "really bad Sjogren's." He recommended that the eye doctor do the Schirmmer's test when he's there in February to get his eyes checked.

Thanks for all the help...you guys are great!!!

Take care, Everyone.

Margaret

#17 Eos

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Posted 11 December 2009 - 03:05 PM

You can go to an eye doctor and get a formal dry eye test done. Its not painful, just awkward because they try to make your eyes tear. But it is helpful to diagnose Sjogren's. Good luck!