Oral and maxillofacial manifestations of systemic sclerosis

Systemic sclerosis (SSc) is a systemic autoimmune rheumatic disease characterized by fibrosis, microvascular damage, and immune dysregulation. Although its cutaneous and systemic features have been extensively delineated, its oral and maxillofacial features are not well studied. Microstomia is one of the most incapacitating oral symptoms in SSc, hampering oral hygiene, and dental treatment. Xerostomia leads to increased caries susceptibility, whereas periodontal disease and vascular insufficiency hasten tissue breakdown, leading to attachment loss and bone resorption. Temporomandibular joint involvement undermines jaw mobility, leading to discomfort, and a reduction in food intake. Scleroglossus and frenum fibrosis impair clear speech. Orofacial exercises can strengthen mouth opening. Dental implants and regenerative procedures appear promising but need to be undertaken with careful patient selection. This review synthesizes current evidence on the prevalence, pathogenesis, and clinical management of SSc oral and maxillofacial manifestations and their complications.