Routine dental exams that detect changes—some of which you may not even be aware of—in the mouth play a significant role in the management of lupus. Lupus is a chronic autoimmune disease that can affect multiple parts of the body, including your mouth.
Your dentist can check for lesions inside the cheeks and on the lips and roof of your mouth. Oral problems that are detected may be related to the disease process itself, medications, or secondary infections.
Oral Symptoms of Lupus
Red ulcers in your mouth can be a sign of active lupus disease. Since these discoid lesions aren't always painful, if you have lupus, your dentist can check for oral lesions inside the mouth and on the tongue during your regular dental exams.
It may be necessary to biopsy any lesions discovered to determine if they are symptoms of active lupus disease–commonly known as periods of flare. Sometimes oral lesions are not a sign of active disease but are a reaction to medications used to treat lupus.
Oral Side Effects of Lupus Treatment
Drugs, such as non-steroidal anti-inflammatories, corticosteroids, antimalarials, and immunosuppressives, used to treat lupus symptoms can cause oral complications. Reactions to these drugs can change the color of the lining on the palate of your mouth—often a side effect of antimalarial drugs.
Oral thrush yeast infection is an oral fungal infection that can develop due to a suppressed immune system from taking corticosteroids or immunosuppressive drugs. Immunosuppressant drugs can also cause gingival hyperplasia–enlargement of gum tissue. Therefore, it's important to practice good oral hygiene.
Swelling of the tongue and lip may also occur as a side effect of immunosuppressive medications. While lip swelling is common, a tongue that swells within minutes is a severe reaction that can block the airway. Slight tongue swelling that occurs slowly isn't as serious and may be due to inflammation. Your dentist may prescribe steroids to reduce inflammation and swelling.
Herpes simplex—a viral infection—is another oral complication that may occur as a reaction to medications. Oral herpes generally presents as painful fever blisters or cold sores on the lips. Although uncommon, the infection can occur on the tongue and gums or upper part of the throat.
Co-Existing Autoimmune Disease
Sjogren's syndrome is a common chronic autoimmune disorder that often occurs with lupus. The disease affects the salivary glands in the mouth, causing dry mouth. Saliva keeps oral tissue inside the mouth moist and helps neutralize acids that can lead to cavities.
Lack of saliva production makes you more susceptible to tooth decay as well as oral fungal infections such as angular cheilitis, which is characterized by sores in the corners of the mouth. Dry mouth can also cause red or white spots on the tongue. A tongue that appears shiny and red is another sign of dry mouth related to Sjogren's syndrome. Other oral symptoms of Sjogren's syndrome include cracks or deep grooves in the tongue, a burning sensation that affects the tongue, and trouble swallowing due to dry mouth.