Autoimmune diseases and their manifestations on oral. Summary autoimmune diseases impact the oral cavity both directly and indirectly. Some of these diseases affect the oral cavity and have a negative effect on oral health. A number of oral manifestations of systemic disease have been covered previ. Oral lesions are observed commonly in autoimmune blistering skin diseases. Autoimmune bullous diseases are a group of chronic inflammatory disorders caused by autoantibodies targeted against structural proteins of the desmosomal and hemidesmosomal plaques in the skin and mucosa, leading to intraepithelial or subepithelial blistering. Treatments may not be curative, and may only improve the patients quality of life. Thus, until proven otherwise by means of histologic evaluation, all leukoplakias must be considered precancerous. Most diseases of oral mucosa are either autoimmune in nature or are the results of immunologicallymediated events. Oral cavity anatomical and physiological specificities. Vesiculobullous autoimmune diseases with oral mucosa.
Because patients initially present to the otolaryngologists office, a full history and a complete physical examination are emphasized for all patients. Immunemediated diseases along with lesions in oral cavity. Scleroderma and vasculitis have a significant, lifelong effect on oral health. The disorder occurs when the immune system mounts an attack against cells of the oral mucous membranes for unknown reasons autoimmune disorder. These include recurrent aphthous stomatitis ras, erythema multiforme em, the bullous diseases pemphigus vulgaris pv and mucous membrane pemphigoid mmp and lichen planus lp.
Patients who develop cd before age 7 are at greatest risk of negative effects in their permanent dentition. Autoimmune diseases may also be reflected in changes in the oral cavity that represent the first sign of the disease, or they may occur simultaneously with or later in the course of the disease. Gaddey, md on examination, the oral cavity may exhibit manifestations of underlying systemic disease and serve as an. The purpose of the immune system is to defend the body from invading microorganisms. Lack of saliva predisposes patients to develop tooth cavities. As such, there is a growing need for the oral health practitioners to be aware of how autoimmune disease impacts the oral cavity. Hormonal changes can cause symptoms to change, sometimes for the better but sometimes for the worse. Pdf autoimmune diseases and their manifestations on oral. Overall 1676 subjects aged 3040 years old from stockholm. Introduction concept of immunity and autoimmunity human body has got capacity to resist almost all types of organisms or toxins that tend to damage the tissues and organs. The xerostomia is responsible for creating different manifestations of ss at the level of oral cavity. Symptoms can usually be managed, but people who have oral lichen planus need regular monitoring because they may be at risk of developing mouth cancer in the affected areas.
In the past, mmp was known by several terms, including benign mucous membrane pemphigoid, cicatricial pemphigoid and ocular or oralgingival pemphigoid. Sjogrens syndrome is the second most common autoimmune disease, according to medscape. Hypothesis was that poor oral health associates with incidence of autoimmune diseases. Most body parts can be affected by these diseases, and even though treatments exist to control symptoms, there are no cures. Many autoimmune diseases may have ear, nose, and throat ent manifestations representing a diagnostic challenge for clinicians as they often constitute the initial sign of an otherwise asymptomatic autoimmune disease. The performance of a larger number of studies, focusing on the followup of oral lesions associated with autoimmune vesiculobullous diseases, is of the utmost importance so that it will be possible to obtain an understanding of the best way to control these lesions in the daily routine of the clinic. Oral manifestations of systemic diseases the oral cavity is. Oral signs are frequently the first manifestation of autoimmune diseases. The addition of an autoimmune disease is referred to as secondary sjogren syndrome, 24.
For the oral cavity, this means an attack on the salivary glands that leads to a significant decrease in the production of saliva. Oral lesions can be the predominant or minor clinical manifestation of a given disease. Long standing oral health conditions may become worse over time. Granulomatous diseases cause a great range of symptoms not only in the head and neck but also throughout the body. The autoimmunityoral microbiome connection nikitakis. Blistering mucocutaneous diseases of the oral mucosa a. The pdf file you selected should load here if your web browser has a pdf reader plugin installed for example, a recent version of adobe acrobat reader. Autoimmune diseases are disorders caused by a reaction of an individuals immune system to the tissues or organs of the persons own body. Indeed, an early diagnosis can play a decisive role in improving the quality of treatment strategies as well as quality of life.
Autoimmune diseases and their manifestations on oral cavity. Autoimmune diseases of oral cavity most diseases of oral mucosa are either autoimmune in nature or are the results of immunologicallymediated events. We investigated the association between oral health and autoimmune diseases in a cohort of swedish adults. Oral infections causing systemic diseases biomedical and.
Ss is one of the most common autoimmune diseases with a prevalence between 0. However, in reporting the results of the first international consensus on mucous membrane. There are oral manifestations of many autoimmune diseases. Children with cd are at increased risk for dental caries. For this reason, dentists play an important role in the detection of emerging autoimmune pathologies. Aravindha babu department of oral pathology, sree balaji dental college and hospital, bharath university, pallikaranai, chennai 600100. Diagnosis and clinical management article pdf available in journal of immunology research 20181. Oral manifestations of autoimmune blistering diseases amoxicillin sexually transmitted diseases autoimmune diseases impact the oral cavity both directly and indirectly and are increasing in prevalence. This can be obtained thanks to specific knowledge of oral manifestations of autoimmune. The most common presentation of mmp in the oral cavity has been described as desquamative gingivitis, however this clinical presentation is also seen in other autoimmune oral diseases such as erythema multiforme, dermatitis herpetiformis, pemphigus vulgaris. Immunity in the oral cavity british society for immunology.
Clinicians must bear in mind that it is uncommon to see vesicles or bullae intraorally, as they soon rupture, leaving erosions or ulcers. Pemphigus vulgaris pv and bullous pemphigoid bp are the earliest recognized autoimmune blistering diseases, and, together, they account for about one half of the autoimmune blistering diseases. The oral impact of celiac disease dimensions of dental. Therefore, the tcells activate and destroy these cells. Improving the oral health of patients with autoimmune diseases may reduce morbidity associated with such diseases.
Dental considerations in autoimmune diseases presented by amjath k malabar dental college 2. Diagnostic procedures for autoimmune vesiculobullous. Bp has also been reported in association with other autoimmune diseases like diabetes. Most body parts are affected by these diseases and although the treatments exist to control these symptoms, there are no cures. Some of these diseases affect the oral cavity and have a negative effect on oral.
About 90 percent of the patients are women, and approximately 3 percent of all women over age 50 are affected by the disease. Pemphigus vulgaris and bullous pemphigoid are the earliest recognized autoimmune blistering diseases, and, together, they account for about one half of the autoimmune blistering diseases. Due to failure of an organism to recognize its own constituent parts as self leading to an immune response against its own cells and tissues. These diseases can affect most body parts, and even though treatments exist to control symptoms, there are no cures. Diseases and disorders caused by oral microorganisms are very common and economically important, in particular dental caries loss of tooth integrity caused by. Autoimmune diseases affecting the oral cavity may demonstrate clinical, histologic, and in some cases similar immunopathologic patterns. The tcells identify the normal cells in the skin and mucous membranes of various parts of the body as faulty cells. Oral manifestations of dermatological disorders open. The oral cavity is a unique anatomical structure, characterised by the juxtaposition of soft and hard tissues and which is continuously subject to challenge by the external environment and foreign material. Among the immune mediated oral lesions the most important are lichen planus, pemphigus, erythema multiformi, epidermolysis bullosa, systemic lupus erythematosis.
Autoimmune diseases of the oral cavity systemic lupus. The lesions of oral cavity in dermatological disorders deserve special attention, considering that they may be the presenting clinical feature or the only sign of these disorders. Autoimmune disease manifestations in the oral cavity. Factor responsible for differences in immunity are age, nutrition and genetic factors. The oral mucosa is frequently affected in these diseases, in particular, in mucous membrane pemphigoid, pemphigus vulgaris, and. After systemic diagnosis, oral lesions benefit from specialized care by dentists in collaboration with the medical team.
As such, there is a growing need for the oral health practitioners to be aware of how autoimmune disease impacts the. Bullous pemphigoid of the oral cavity 2 case reports with. Some of these drugs are used to make the body less likely to reject a. If you would like more information about how to print, save, and work with pdfs. The lesions may be selflimiting and undergo remission spontaneously. Oral manifestations of autoimmune blistering diseases. Immune mediated diseases of oral cavity are uncommon. Some of the autoimmune diseases affect the oral cavity and may have a negative effect on the oral health.
Immunosuppressant drugs are a class of drugs that suppress, or reduce, the strength of the bodys immune system. Immunerelated disorders of the oral cavity may occur as primary disease process, secondary to systemic disease or neoplasm, or as a reaction to medications and other agents. Oral infections upregulate a number of systemic inflammatory reactions that, in turn, play a role in the development of systemic diseases. Immunology is defined as the study of the molecular cells, organs and system for the recognition and disposal of foreign materials. Careful examination of the oral cavity may reveal findings. This group includes viral diseases, autoimmune mucocutaneous diseases, diseases that probably have an. These include recurrent aphthous stomatitis ras, erythema multiforme em, the bullous diseases pemphigus vulgaris pv and mucous. Dermatological diseases, besides involving the skin and its appendages may also involve the oral cavity. Systemic autoimmune and inflammatory diseases often manifest oral lesions in their earliest stages, and early diagnosis, which may be spurred by a dental examination, is key for improved outcomes. The main signs of the syndrome are related to the oral cavity. Vesiculobullous diseases represent a heterogeneous group of dermatoses with widely varying clinical manifestations, which have been the subject of intense investigation in recent years. Autoimmune bullous diseases are rare but represent a potentially devastating group of mucocutaneous diseases characterized by the presence of tissuebound immunoreactants and circulating autoantibodies against various target antigens with disease specificity 1.