Scleroderma and CREST syndrome: a case report in dentistry

Area of Science:

• Rheumatology
• Autoimmune Diseases
• Scleroderma Spectrum Disorders

Background:

• CREST syndrome, a subset of systemic sclerosis, presents with calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasias.
• This case highlights a 72-year-old female diagnosed with CREST syndrome, presenting with oral symptoms impacting deglutition and denture stability.

Observation:

• The patient exhibited characteristic extra-oral findings of CREST syndrome, including taut skin, facial maculae, telangiectasias, and acrocyanosis.
• Intra-oral examination revealed tongue rigidity and speckled lesions on the hard palate and vestibule, suggesting progression to Sjogren's syndrome.

Findings:

• The patient was managed for Sjogren's syndrome, focusing on symptomatic treatment for xerostomia.
• Dental management included saliva stimulants, substitutes, topical fluoride applications, and rigorous oral hygiene protocols.

Implications:

• Effective dental care and prophylaxis are vital for preventing xerostomia-related complications like rampant caries in patients with CREST syndrome progressing to Sjogren's syndrome.
• Regular dental assessments and patient education are essential for maintaining oral health in this complex patient population.