[Oral symptoms of immunologic disorders. Part I. Systemic autoimmune diseases]

Polysystemic autoimmune diseases often cause orofacial and stomatognathic symptoms. Inflammation of the temporomandibular joint only rarely and slightly reduces the range of mouth opening (rheumatoid arthritis), which is much more restricted in systemic sclerosis due to fibrosis of perioral soft tissues. Weakness of masticatory and pharyngeal muscles in idiopathic inflammatory myopathies results in dysphagia and dystonia. Ulcerations, petechiae, teleangiectasia, and lichenoid lesions are the characteristic symptoms of oral mucosal involvement, but drugs used in systemic treatment can also cause very similar side effects. Salivary gland hypofunction (Sjögren's syndrome) is common, and in addition to the subjective complaints, leads to objective pathologic alterations such as oral mycotic infections, purulent sialadenitis, and increased caries prevalence. The side effects of steroid administration should be taken into account also during dental treatments. Regular dental follow-up and treatment is a basic part of the complex care of these patients in order to diagnose and cure oral abnormalities and salivary gland hypofunction in time. Impairment of hand functions (rheumatoid arthritis, scleroderma) reduces the oral hygienic activity and therefore special devices, local antiseptics and local fluoride preparations are necessary.