Wednesday, 26 June 2013

Part 2 Immune System Gone Wild. Sjogren's National Conference Dr. Papas

Dr Athena Papas was an outstanding speaker at the National Sjogrens Conference. She is the Head of the Division of Oral Medicine and Public Health Research at Tufts University School of Dental Medicine in Boston. Her talk was full of useful and practical information for people with Sjogren's Syndrome.

On one of her first slides we heard that a lack of saliva can also cause trouble speaking and swallowing. We also learned that it occurs in a 9:1 ratio of women:men. This means it can take even longer for men to be diagnosed.  

                                                      9 out of 10 with Sjogren's are women
As saliva in the mouth goes down the decay and erosion goes up.  She suggested the use of fluoride to help stall decay. If your gums recede then you will be more prone to root decay.  Acidic drinks and juices may cause rapid erosion quickly. The best drinks are milk and water according to a chart presented that detailed the acidity (pH) of common drinks.

Dr Papas mentioned sialoliths or salivary "stones"  which can cause pseudomonas infection of salivary glands and showed a slide of a patient with lichen planus in the mouth.  She commented that lichen planus can get away on you fast make sure you have it seen. If you have candida yogurt may help.

Acid reflux is a common complaint and it needs to be controlled to protect the teeth from thinning. If your amalgam fillings are really shiny it may be that the acid from reflux is polishing them.


Psych meds in general are the most drying group of medications. Lyrica is one of the most drying, as is Prozac.  

Dr Papas was the principal investigator on the dose escalation of Salagen. She says cytokines block salivary secretion. Salagen makes those glands that still produce saliva work harder. She also demonstrated a method of massaging the salivary glands to stimulate them.

She suggested getting fluoride varnish every 3 months from the dentist for tooth protection and the use of prescription fluoride toothpaste that can reharden the tooth surface. MI Paste contains ACP (calcium phosphate) and is good, as is Caphosol. 

Dr Papas made comments about the benefits of implants for people with Sjogren's.

Near the end of the talk Dr Papas presented a slide summarizing treatments:
Use a sialogogue (salivary substitute)
Use prescription strength fluoride
Use lubrication
Use calcium and phosphate rinses
Use MI paste
Stimulate with Xylitol gum
Stimulate salivary glands with massage after heating
Use implants when teeth are extracted

These are just the points that particularly interested me. The whole talk was informative and I hope to hear Dr Papas again in the future. 

To see the post about Part 1 of the Sjogren's National Conference click here

Other Sjogren's posts:

Sjogren's makes Life More Complicated

2012 National Patient Conference

Sjogren's Products

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