3D radiotherapy in the parotid gland and its dosimetric relationship with salivary flow and quality of life in patients with head and neck cancer

Aim: Hyposalivation and dry mouth affect the quality of life in patients with Head and Neck Cancer, who did the treatment with radiotherapy. Thus this study has the objective to evaluate the dosimetric relationship between 3D radiotherapy and changes in salivary flow, xerostomia and quality of life in patients with head and neck cancer according to the volume of the irradiated parotid gland. Methods: 23 patients with cancer in the head and neck area and in need of 3D radiotherapy were followed up during radiotherapy treatment, and the parotid gland (PG) design was also performed in radiotherapy planning. Questionnaires were carried out to determine xerostomia and quality of life, while the salivary flow was determined through calculations regarding the collection and weighing of saliva. Such data were collected in three moments: before the beginning of the radiotherapy treatment (D0), in the middle of the treatment (D1) and at the end of it (D2). The numerical variables are represented by measures of central tendency and measures of dispersion. Results: when associating the salivary flow, the xerostomia questionnaire and the OHIP-14, a statistically significant difference was found (p-value <0.001), as well as when comparing some volumes of irradiated PG with the OHIP-14. However, no relationship was found between dosimetric data, xerostomia and hyposalivation. Conclusion: patients undergoing 3D radiotherapy for malignant neoplasms in the head and neck region had decreased salivary flow, increased complaints of dry mouth and decreased quality of life. However, it was not possible to establish a statistically significant correlation between these findings and the volumes of irradiated parotids

Factors Associated with Hyposalivation in Brazilian Adults

ABSTRACT Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.

Xerostomia and dysgeusia in the elderly: prevalence of and association with polypharmacy

Xerostomia is defined as the perception of dry mouth, and dysgeusia, as a change in taste. Both are common complaints in the elderly, especially among those making use of polypharmacy drug combinations. Aim: This study aimed to determine the prevalence of xerostomia and dysgeusia and to investigate their association with polypharmacy in the elderly. Methods: older people under follow-up at the Multidisciplinary Elderly Center of the University Hospital of Brasília were interviewed and asked about health problems, medications used, presence of xerostomia and dysgeusia. Descriptive statistics were used to determine the prevalence of the symptoms surveyed. The chi-square test was used to investigate the relationship between xerostomia and dysgeusia and polypharmacy. Secondary associations were performed using binomial logistic regression. Results: Ninety-six older people were evaluated and of these, 62.5% had xerostomia and 21.1%, had dysgeusia. The average number of medications used was 4±3 medications per individual. Polypharmacy was associated with xerostomia but not dysgeusia. It was possible to associate xerostomia with the use of antihypertensive drugs. Conclusion: Xerostomia was a frequent complaint among elderly people making use of polypharmacy, especially those using antihypertensives. Antihypertensives and antidepressants were used most drugs by the elderly and exhibited interactions with drugs most prescribed in Dentistry. Two contraindications were found between fluconazole and mirtazapine; and between erythromycin and simvastatin

Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly: a cross-sectional study

Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly

Análise comparativa do tratamento do ardor bucal com terapia a laser de baixa intensidade e estimulação elétrica nervosa transcutânea: um ensaio clínico randomizado / Comparative analysis of the treatment of burning mouth with low-intensity laser therapy and transcutaneous electrical nerve stimulation: a randomized clinical trial

Introdução: O manejo de pacientes com ardor bucal é um desafio no cotidiano clínico da odontologia. Objetivo: Comparar o efeito da Terapia a Laser de Baixa Intensidade (LLLT) e da Estimulação Elétrica Nervosa Transcutânea (TENS) no tratamento do ardor bucal. Metodologia: Ensaio clínico randomizado constituído por 25 pacientes com ardor bucal que foram tratados por TENS (n=12) e por LLLT (n=13). Os protocolos de tratamento foram aplicados semanalmente por 8 semanas. O teste análise de variância (ANOVA) dois fatores foi usado para verificar se existia diferença significativa entre os tempos T0 (antes de iniciar o tratamento), T1 (após a 4ª sessão de tratamento), T2 (após a 8ª sessão de tratamento) e T3 (30 dias após o término do tratamento) em relação aos sintomas, analisados por meio da Escala Visual Analógica (EVA), fluxo salivar não estimulado, xerostomia e disgeusia com as intervenções de TENS e LLLT. Resultados: A maioria dos pacientes foi do sexo feminino no período pós-menopausa com média de idade no grupo TENS de 59,25 anos e no grupo LLLT de 62,08. Hipertensão e dislipidemia foram as alterações sistêmicas mais frequentes. Ansiedade e depressão foram os únicos transtornos psiquiátricos relados. A maioria dos pacientes fazia uso de medicamentos como anti-hipertensivos e antidepressivos. Não foram observadas variações expressivas no que se refere a xerostomia e a disgeusia nos dois grupos analisados. A TENS e a LLLT foram eficazes na redução dos sintomas relatados pelos pacientes (p˂0,001), entretanto, observou-se entre os tempos T2 e T3 que o grupo LLLT apresentou uma melhor resposta quando comparado ao TENS (p=0,003). Os pacientes do grupo TENS apresentaram aumento do fluxo salivar entre os tempos T1 e T2, enquanto o grupo LLLT apresentou uma diminuição (p=0,052). Conclusão: A TENS e a LLLT foram eficazes na redução dos sintomas do ardor bucal durante o tratamento e 30 dias após o término do tratamento, sendo que o grupo LLLT apresentou uma melhor resposta na sessão de acompanhamento pós-tratamento quando comparado ao grupo TENS (AU).

Introduction: The management of patients with burning mouth is a challenge in the clinical routine of dentistry. Objective: To compare the effect of Low Intensity Laser Therapy (LLLT) and Transcutaneous Electrical Nerve Stimulation (TENS) in the treatment of burning mouth. Methodology: Randomized clinical trial consisting of 25 patients with burning mouth who were treated with TENS (n=12) and LLLT (n=13). Treatment protocols were applied weekly for 8 weeks. The two-way analysis of variance (ANOVA) test was used to verify whether there was a significant difference between the times T0 (before starting treatment), T1 (after the 4th treatment session), T2 (after the 8th treatment session) and T3 (30 days after the end of treatment) in relation to symptoms, analyzed using the Visual Analogue Scale (VAS), unstimulated salivary flow, xerostomia and dysgeusia with TENS and LLLT interventions. Results: Most patients were female in the postmenopausal period, with a mean age of 59.25 years in the TENS group and 62.08 in the LLLT group. Hypertension and dyslipidemia were the most frequent systemic alterations. Anxiety and depression were the only psychiatric disorders reported. Most patients used drugs such as antihypertensives and antidepressants. Significant variations were not observed with regard to xerostomia and dysgeusia in the two groups analyzed. TENS and LLLT were effective in reducing the symptoms reported by patients (p˂0.001), however, it was observed between times T2 and T3 that the LLLT group showed a better response when compared to TENS (p=0.003). Patients in the TENS group showed an increase in salivary flow between times T1 and T2, while the LLLT group showed a decrease (p=0.052). Conclusion: TENS and LLLT were effective in reducing the symptoms of burning mouth during treatment and 30 days after the end of treatment, and the LLLT group showed a better response in the posttreatment follow-up session when compared to the TENS group (AU).

Síndrome da ardência bucal: relato de caso clínico / Oral burning syndrome: a clinical case report

O presente estudo teve como objetivo principal descrever por meio de um relato de caso clínico o diagnóstico e a conduta clínica de uma paciente portadora da Síndrome da Ardência Bucal (SAB). A SAB é definida como uma dor crônica e de difícil diagnóstico e difícil tratamento. O local mais acometido pela SAB é a língua, lábios e mucosa jugal, mas pode estar presente em qualquer parte da mucosa oral, causando desconforto e interferindo na qualidade de vida do paciente. Paciente do sexo feminino, leucoderma, 39 anos, sem histórico de doenças sistêmicas, saúde geral em bom estado, procurou atendimento no Centro Universitário da Serra Gaúcha ­ FSG por apresentar sensação de ardência recorrente na língua e na mucosa, que aumentava em momentos de estresse ou durante a ingestão de alimentos cítricos, picantes ou quentes. A paciente realizou exames complementares (hemograma completo, glicemia de jejum, exame de vitamina B12) e primeiramente, iniciou-se o tratamento com antifúngico tópico para remoção de uma camada esbranquiçada presente no dorso da língua. Após a remissão desta, foi utilizado AD-Muc tópico 2 vezes ao dia, durante 2 semanas e relatou ter reduzido seus sintomas em torno de 70%. A paciente ainda apresentava xerostomia e, então foi prescrita saliva artificial. A paciente teve a regressão total de seus sintomas. Pode-se concluir que diversos fatores etiológicos estão relacionados com a SAB, porém sua causa específica permanece desconhecida. O tratamento é paliativo, entretanto, o Ad-muc tópico se mostrou eficaz na redução da sintomatologia da SAB juntamente com o uso da saliva artificial(AU)

The present study aimed to describe, through a clinical case report, the diagnosis and clinical conduct of a patient with Burning Mouth Syndrome (BMS). BMSis defined as chronic pain that is difficult to diagnose and difficult to treat. The site most affected by BMS is the tongue, lips, and cheek mucosa, but it can be present in any part of the oral mucosa, causing discomfort and interfering with the patient's quality of life. Female patient, leucoderma, 39 years old, with no history of systemic diseases, general health in good condition, sought care at the Centro Universitário da Serra Gaúcha - FSG for presenting a recurrent burning sensation in the tongue and mucosa, which increased in times of stress or while eating citrus, spicy or hot foods. The patient underwent complementary tests (complete blood count, fasting blood glucose, vitamin B12 test) and first, treatment with topical antifungal was started to remove a whitish layer present on the back of the tongue. After remission, topical AD-Muc was used twice a day for 2 weeks and reported to have reduced his symptoms by around 70%. The patient still had xerostomia and then artificial saliva was prescribed. The patient had a total regression of her symptoms. It can be concluded that several etiological factors are related to SAB, but its specific cause remains unknown. Treatment is palliative, however, topical Ad-muc is effective in reducing the symptomsof BMS also with the use of artificial saliva(AU)

Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

ABSTRACT Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods: Thirty subjects with a history of xerostomia and subjects withunstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student's t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p<0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p<0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p<0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was notstatistically significant in both groups (p<0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

Etiologia e fatores associados à halitose: uma revisão integrativa da literatura / Etiology and factors associated with halitosis: an integrative literature review

Objetivo: avaliar quais as possíveis causas e quais são os fatores associados ao surgimento da halitose. Métodos: foi realizada uma revisão nos bancos de dados PubMed e SciELO, utilizando os descritores e sinônimos MeSH organizados em lógica booleana: 'Halitosis' AND 'Risk Factors' OR 'Association' OR 'Etiologies', com as seguintes etapas: identificação dos artigos, triagem, elegibilidade e inclusão. Apenas artigos publicados entre os anos de 2015-2020, ensaios clínicos randomizados, estudos transversais ou de coorte foram incluídos na revisão. Foram excluídos protocolos de estudos e os artigos que não estavam nos critérios e objetivo desta revisão. Resultados: de 240 artigos encontrados, 22 foram inclusos. Desses, 50% demonstraram que a falta ou a deficiência dos hábitos de higiene oral se relacionam com a halitose. Ainda, 40,9% deles se referem à saburra lingual como um forte fator etiológico e 36,4% demonstram que a doença periodontal está diretamente associada com o mau hálito. Além disso, em relação a outras condições locais e sistêmicas, xerostomia (13,6%), doença gastrointestinal e refluxo laringofaríngeo (9,1%), rinite e diabetes (4,5%) também demonstraram associação. Considerações finais: a halitose pode estar associada com higiene bucal, saburra lingual, doença periodontal, alguns hábitos e quadros sistêmicos.(AU)

Objective: to evaluate the possible causes and what are the factors associated with the onset of halitosis. Methods: a review was performed in the PubMed and SciELO databases, using the descriptors and synonyms MeSH organized in Boolean logic: 'Halitosis' AND 'Risk Factors' OR 'Association' OR 'Etiologies', with the following steps: identification of articles, screening, eligibility and inclusion. Only articles published between 2015- 2020; randomized clinical trials; cross-sectional or cohort studies were included in the review. Study protocols and articles that were not in the criteria and objective of this review were excluded. Results: Of 240 articles found, 22 were included. Of those, 50% showed that the lack or deficiency of oral hygiene habits are related to halitosis. Furthermore, 40.9% of them refer to tongue coating as a strong etiological factor and 36.4% demonstrate that periodontal disease is directly associated with bad breath. Moreover, in relation to other local and systemic conditions, xerostomia (13.6%), gastrointestinal disease and laryngeal reflux (9.1%), rhinitis and diabetes (4.5%) also demonstrated an association. Final considerations: Halitosis may be associated with oral hygiene, lingualcoating, periodontal disease, some habits and systemic conditions.(AU)

Salivary Glands, Saliva and Oral Findings in COVID-19 Infection

Abstract The world is under the threat of the novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite several efforts to contain the disease spread, it still constitutes a public health emergency of international concern. Several published reports in the scientific literature called attention of the oral cavity as the potential route of infection, the implications for dental practice and the use of saliva in the diagnose of the COVID-19. The aim of this article is to provide an overview of the literature on the salivary glands and saliva in the context of SARS-CoV-2 infection. A brief discussion of taste disturbances and oral findings in COVID-19 patients is also presented. The literature shows that SARS-CoV-2 could infect the salivary glands. It is not possible, however, to make speculations regarding them as reservoirs for the SARS-CoV-2. In addition, patients with COVID-19 presented several oral repercussions, including hyposalivation and taste disturbances. A few reports showed oral ulcers and blisters associated with SARS-CoV-2 infection. However, it remains not fully understood and might lead to erroneous assumptions. Overall, further studies are necessary to understand the real role of salivary glands and saliva in the context of SARS-CoV-2 infection.

Avaliações salivares em odontopediatria e perfil metabólico in vitro dos Streptococcus mutans / Salivary assessments in pediatric dentistry and in vitro metabolic profile of Streptococcus mutans

O objetivo da presente tese foi analisar características salivares e microbiológicas relacionadas com a cárie dentária em crianças. Para isso, foram realizados três estudos. O primeiro foi uma revisão crítica da literatura que objetivou avaliar se crianças e adolescentes com hiposalivação apresentam mais lesões de cárie do que pacientes com fluxo salivar normal. Através de busca sistemática da literatura, foram selecionados 9 estudos, sendo 5 transversais e 4 coortes. Apenas uma coorte encontrou associação entre baixo fluxo salivar e aumento da presença de cárie, enquanto os outros 8 estudos não observaram essa relação. No entanto, foi observada grande heterogeneidade entre as metodologias, além da ausência de um parâmetro único para definir a hiposalivação nos pacientes abaixo de 18 anos. Dessa forma, não foi encontrada evidência que permita avaliar a associação entre a presença de hiposalivação e aumento na experiência de cárie. O segundo estudo foi uma avaliação clínica objetivando comparar o perfil metabolômico da saliva de bebês no período prédental antes a após a realização de um protocolo de limpeza bucal. Foi feita coleta inicial de saliva total não estimulada, sendo repetida 5 minutos após a limpeza da mucosa bucal com gaze embebida em água filtrada, para posterior análise por Ressonância Magnética Nuclear (RMN). Foi encontrada menor concentração de componentes como lactose, açúcares, acetato e lactato nas amostras após a limpeza da cavidade bucal. Além disso, observou-se maior quantidade de lactose na saliva dos participantes que faziam amamentação exclusiva do que nos bebês que faziam aleitamento misto. Verificou-se que a higienização bucal prévia a coleta salivar foi efetiva na redução da concentração de alguns metabólitos extrínsecos. O terceiro estudo foi um ensaio laboratorial objetivando caracterizar o perfil dos metabólitos de baixo peso molecular secretados pelo crescimento e maturação do biofilme de uma cepa de Streptococcus mutans, usando blocos dentários bovinos selecionados a partir da sua microdureza superficial (354,9 ±8,6 kg/mm2). O crescimento em biofilme (B) foi comparado com a cultura em suspensão celular (SC) durante diferentes períodos (2, 4 e 6 dias). Foram realizadas análises em espectrômetro de RMN de 500 MHz, além da avaliação final da microdureza transversal dos blocos. Verificou-se que o principal metabólito consumido foi a sacarose, sendo o consumo estatisticamente menor em SC-2d do que em B-2d, e no grupo B-6d do que nos grupos B-2d e B-4d. Os principais compostos secretados foram lactato e frutose. Houve maior liberação de lactato no grupo SC-2d do que em B-2d, e em B-6d do que B-4d. A perda mineral dos blocos dentários foi semelhante entre os grupos experimentais (p>0,05). Desse modo, concluise que: (1) não há evidência científica disponível até o momento que permita verificar a associação entre a hiposalivação e a cárie dentária em crianças e adolescentes; (2) a realização de um protocolo de limpeza da mucosa bucal de bebês no período prédental previamente à coleta salivar é capaz de reduzir a concentração de metabólitos extrínsecos; e (3) a atividade metabólica do S. mutans promove o consumo de sacarose e a liberação principalmente de lactato e frutose. (AU)

The aim of this thesis was to analyze salivary and microbiological characteristics related to dental caries in children. For this, three different studies were carried out. The first one was a critical review of the literature that aimed to assess whether children and adolescents with hyposalivation have more dental caries lesions than patients with normal salivary flow. A systematic literature search was performed which 9 studies were selected, 5 cross-sectional and 4 cohorts. Only one cohort found an association between low salivary flow and an increasing in caries presence, while the other 8 studies did not observe this relationship. However, great heterogeneity was observed between the methodologies, in addition to the absence of a single parameter to define hyposalivation in patients under 18 years. Thus, no evidence was found to assess the association between the presence of hyposalivation and increased dental caries experience. The second study was a clinical evaluation aiming to compare the metabolomic profile of the saliva of babies in the pre-dental period before and after performing a mouth cleaning protocol. Initial collection of total unstimulated saliva was performed, being repeated 5 minutes after cleaning the oral mucosa with gauze soaked in filtered water, for further Nuclear Magnetic Resonance (NMR) analysis. The samples were analyzed by Nuclear Magnetic Resonance (NMR). Lower concentrations of components such as lactose, sugars, acetate, and lactate were found in the samples after cleaning the oral cavity. In addition, a higher amount of lactose was observed in the saliva of participants who were exclusively breastfeeding than in babies who were mixed breastfeeding. It was verified that oral hygiene prior to salivary collection was effective in reducing the concentration of some extrinsic metabolites. The third study was a laboratory test aiming to characterize the low molecular weight metabolites profile secreted by the growth and maturation of the biofilm of a strain of Streptococcus mutans, using bovine dental blocks selected from their surface microhardness (354.9 ± 8.6 kg / mm2). The growth in biofilm (B) was compared with that observed in cell suspension (CS) during different periods (2, 4 and 6 days). NMR analyzes were performed on a 500 MHz spectrometer, in addition to the final assessment of the crosssectional microhardness of the blocks. It was found that the main metabolite consumed was sucrose, with statistically lower consumption in CS-2d than in B-2d and in group B6d than in groups B-2d and B-4d. The two main secreted compounds were lactate and fructose. There was a higher lactate release in the CS-2d group than in B-2d and B-6d than in B-4d. The mineral loss of the dental blocks was similar between the experimental groups (p> 0.05). Therefore, it is concluded that: (1) there is no scientific evidence available so far that allows verifying the association between hyposalivation and dental caries in children and adolescents; (2) a protocol for cleaning the oral mucosa of babies in the pre-dental period prior to salivary collection is capable of reducing the concentration of extrinsic metabolites; and (3) the metabolic activity of S. mutans promotes the consumption of sucrose and the release mainly of lactate and fructose. (AU)

Síndrome Sjögren y penfigoide de las membranas mucosas en paciente con antecedente de timoma: Reporte de caso y revisión de literatura / Sjögren Syndrome and Mucous Membrane Pemphigoid in a Patient with a History of Thymoma: Case Report and Literature Review

RESUMEN Los timomas son las neoplasias mediastínicas más comunes en adultos. Los pacientes con timoma son frecuentemente diagnosticados con síndromes paraneoplásicos y generalmente están asociados con varias condiciones autoinmunes. El síndrome de Sjögren (SS) es un trastorno inflamatorio autoinmune, que se caracteriza por la destrucción mediada por linfocitos de las glándulas exocrinas, que conduce a la ausencia de secreción glandular, en particular las salivales y las lagrimales; la hiposalivación puede variar desde una ligera reducción en el flujo de saliva con molestias transitorias, a un grave deterioro de la salud oral y malestar psicológico. El penfigoide de membranas mucosas (PMM) es una enfermedad autoinmune crónica, muestra predominante afectación de la mucosa, afectando con mayor frecuencia la cavidad oral, seguida de la conjuntiva, la cavidad nasal y el esófago; intraoralmente incluye gingivitis descamativa, vesículas, erosiones cubiertas por pseudomembranas y úlceras. El objetivo de este trabajo es presentar el primer caso de una paciente con antecedente de timoma, la cual, conjuntamente presentó SS y PMM; además evidenciar la importancia del manejo multidiciplinario para un diagnóstico preciso y temprano, ya que así, aumenta la eficiencia y la eficacia de la estrategia de tratamiento.

ABSTRACT Thymomas are the most common mediastinal neoplasms in adults. Patients with thymoma are frequently diagnosed with paraneoplastic syndromes and are generally associated with several autoimmune conditions. Sjögren's syndrome (SS) is an autoimmune inflammatory disorder, characterized by the lymphocyte-mediated destruction of the exocrine glands, which leads to the absence of glandular secretion, particularly salivary and lacrimal; hyposalivation can vary from a slight reduction in the flow of saliva with transient discomfort, to a serious deterioration of oral health and psychological distress. Mucous membrane pemphigoid (MMP) is a chronic, autoimmune disease that shows predominant mucosal involvement, most commonly affecting the oral cavity, followed by the conjunctiva, the nasal cavity and the esophagus; intraorally includes scaly gingivitis, vesicles, erosions covered by pseudomembranes and ulcers. The objective of this work is to present the first case of a patient with a history of thymoma, which, jointly presented SS and MMP; also highlight the importance of multidisciplinary management for an accurate and early diagnosis, as this increases the efficiency and efficacy of the treatment strategy.

Orientações odontológicas aos pacientes submetidos à quimioterapia antineoplásica / Dental guidelines for patients undergoing antineoplastic chemotherapy

Objetivo: este trabalho propõe condutas bucais aos pacientes com indicação quimioterápica, a partir de uma revisão de literatura, visto que o paciente é pouco orientado em muitos casos. Material e métodos: a busca foi realizada a partir da base de dados PubMed/Medline. Apenas estudos observacionais e revisões da literatura, em inglês, espanhol e português, publicados entre 2001 e 2019, que abordassem o tratamento antineoplásico e apresentassem complicações bucais foram incluídos. Resultados: dez artigos preencheram os critérios de inclusão. Notou-se que a maioria dos efeitos adversos cessam ao fim da quimioterapia. As principais alterações bucais observadas foram mucosite, xerostomia e candidose. Diversas alternativas terapêuticas se mostraram eficazes, sendo fundamental individualizar o paciente e propor a melhor opção para o quadro específico apresentado. Considerações finais: A participação do cirurgião-dentista na equipe oncológica é extremamente importante, realizando intervenções odontológicas e orientando os pacientes, colaborando para uma melhor qualidade de vida e contribuindo significativamente no prognóstico da doença.(AU)

Objective: This study suggests oral management for chemotherapy patients, through a literature review, considering that patients are poorly instructed in most cases. Material and methods: The search was performed in the PubMed / Medline database. Only observational studies and literature reviews in English, Spanish, and Portuguese, published between 2001 and 2019, which discussed antineoplastic treatment and presented oral complications were included. Results: Ten articles met the inclusion criteria. Most adverse effects were observed to cease at the end of chemotherapy. The main oral changes observed were mucositis, xerostomia, and candidosis. Several therapeutic alternatives seem to be effective, and it is essential to individualize the patient and propose the best option for the specific condition. Final considerations: The participation of dentists in the cancer team is extremely important for performing dental interventions, guiding patients, helping to provide a better quality of life, and contributing significantly to the prognosis of the disease.(AU)

Estudo da prevalência de alterações orais em uma população de pacientes diabéticos do estado da Paraíba / Study of the prevalence of oral changes in a population of diabetic patients in the state of Paraiba

Introdução: o Diabetes Mellitus (DM) atinge cerca de 425 milhões de pessoas no mundo. A cavidade oral pode se tornar susceptível ao surgimento de inúmeras alterações decorrentes do DM como xerostomia, infecções, queilites, alterações gengivais e periodontais. Objetivo: determinar a prevalência de alterações da cavidade oral em pacientes com DM. Material e Método: A amostra foi composta por 118 indivíduos com DM atendidos nas unidades básicas de saúde da família. As características clínicas dos pacientes foram analisadas com auxílio de espátula e iluminação artificial e registradas em um formulário previamente elaborado. Para a análise estatística foi considerado o valor de p<0,05 como significativo. Resultados: da amostra, 38 (32,2%) indivíduos eram do sexo masculino e 80 (67,8%) do sexo feminino, sendo a média de idade de 63,6 anos. O tipo 2 de DM foi o mais frequente (n=109/92,4%). Observou-se alta prevalência de alterações orais, destacando-se: a xerostomia, que exibiu associação com o uso de medicamentos (p=0,049) e a doença periodontal mais frequente em indivíduos com ≤ 60 anos (p<0,0001). A maioria dos indivíduos que fazia uso de hipoglicemiantes orais não apresentou a doença (77,8%; p=0,035). As lesões potencialmente malignas estiveram associadas com o sexo masculino (65,2%; p<0,0001) e com indivíduos de idade acima de 60 anos (82,6%; p<0,015). Conclusão: os indivíduos com DM apresentaram alta prevalência de alterações orais, destacando-se a xerostomia, doença periodontal e alterações potencialmente malignas sugerindo que o diabetes pode influenciar o desenvolvimento e/ou agravamento das doenças orais.(AU)

Introduction: Diabetes Mellitus (DM) affects about 425 million people worldwide. The oral cavity may become susceptible to the emergence of numerous changes from DM, such as xerostomia, infections, cheilitis, and gingival and periodontal changes. Objective: To determine the prevalence of oral cavity changes in patients with DM. Material and Method: The sample consisted of 118 individuals with DM assisted at basic family health units. The clinical characteristics of the patients were analyzed using an oral spatula and artificial lighting, and they were recorded on a form previously prepared. For the statistical analysis, the value of p <0.05 was considered significant. Results: From the sample, 38 (32.2%) individuals were men and 80 (67.8%) were women, with an average age of 63.6 years. Type 2 DM was the most frequent (n = 109 / 92.4%). There was a high prevalence of oral changes, namely xerostomia, which showed association with medication use (p = 0.049) and a higher frequency of periodontal disease in individuals aged ≤ 60 years (p <0.0001). Most of the individuals who used oral hypoglycemic agents did not present the disease (77.8%; p = 0.035). Potentially malignant lesions were associated with the male sex (65.2%, p <0.0001) and individuals over 60 years old (82.6%, p <0.015). Conclusion: Individuals with DM presented a high prevalence of oral changes, especially xerostomia, periodontal disease, and potentially malignant changes, suggesting that diabetes may affect the development and/or aggravation of oral diseases.(AU)

Percepção de boca seca em adultos usuários de próteses removíveis / Perception of dry mouth in adult using of removable prostheses

Objetivo: O objetivo deste estudo foi avaliar a percepção de boca seca em uma amostra de pacientes, de uma clínica de um curso de odontologia, usuários de próteses totais. Métodos: Fizeram parte do estudo 80 pacientes, que responderam a um questionário com 12 questões que caracterizavam o participante e abordava a sensação de boca seca e como a pessoa a percebia. O questionário foi pré-testado antes de sua aplicação definitiva. A análise estatística foi realizada por meio do Teste Exato de Fischer para identificar a associação da xerostomia com as variáveis independentes, com nível de significância de 5%. Resultados: Os participantes do estudo tinham, em média, 62,3 anos de idade e 55% eram do gênero feminino. Metade (50,0%) dos participantes percebiam a boca seca e 72,5% apresentavam alguma doença crônica, principalmente a hipertensão (36,1%) e a diabetes (17,1%) e estas doenças se refletiam na alta (78,8%) utilização de medicamentos de uso contínuo. Apresentavam hábitos bucais nocivos 38,8% dos participantes, principalmente o tabagismo e o bruxismo. A sensação de boca seca foi associada ao gênero, a presença de mau hálito, ao uso de medicamentos contínuos e a sensação de ardência na boca. Conclusão: A partir dos dados coletados pode-se concluir que a xerostomia foi frequente na população estudada e deve ter impacto negativo na qualidade de vida dessas pessoas. (AU)

Aim: The purpose of this study was to assess xerostomia (dry mouth) in a sample of patients who received dental care at a dentistry course clinic and who used dentures. Methods: This study included 80 patients, who answered a questionnaire with 12 questions that characterized the participant and addressed the sensation of dry mouth and how the person perceived it. The questionnaire was pre-tested before its final application. The statistical analyses were performed to identify the differences between the groups, establishing a significance level of 5% and applying the Fisher's exact test. Results: The participants of the study were, on average, 62.3 years of age, 55% of whom were female. Half (50.0%) of the participants perceived dry mouth and 72.5% had some form of chronic disease, mainly hypertension (36.1%) and diabetes (17.1%). These diseases are reflected in the high (78.8%) intake of continuous use medications. This study found that 38.8% of the participants presented harmful oral hygiene habits, mainly smoking and bruxism. The sensation of dry mouth was associated with gender, the presence of bad breath, the intake of continuous use medications, and a burning sensation in the mouth. Conclusion: From the collected data, it is possible to conclude that xerostomia (dry mouth) was frequent in the studied population, most likely causing a negative impact on these people's quality of life. (AU)

Relationship Between Glycemic Control and Coated Tongue in Type 2 Diabetes Mellitus Patients with Xerostomia

Abstract Objective: To examine the relationship between the level of glycemic control and coated tongue in type 2 diabetes mellitus patients with xerostomia. Material and Methods: This study was an analytical survey and involved 64 type 2 diabetes mellitus patients, aged between 17 to 65 years old with 34 males and 30 females. Diagnosis of diabetes mellitus was determined from the patient's medical records. The level of glycemic control was obtained from the patient's last blood sugar examination. Xerostomia was diagnosed with a questionnaire, while coated tongue diagnosis based on clinical features and the severity of coated tongue was assessed using the Kojima index Results: There was a significant relationship between the level of glycemic control and coated tongue (p=0.0026) in type 2 diabetes mellitus patients with xerostomia. Moreover, there was a significant relationship between the level of glycemic control and the severity of the coated tongue (p=0.001). Specifically, poor glycemic control was associated with a higher occurrence of the coated tongue as well as more severe tongue coating Conclusion: There was a significant relationship between the level of glycemic control in and coated tongue in type 2 diabetes mellitus patients with xerostomia. Therefore, diabetes mellitus patients should control their level of glycemic control to prevent the oral complication of the disease.

Systemic Health Characteristics and Self-Reported Xerostomia among Nursing Facility Residents in Iowa-US and Sao Paulo-Brazil / Saúde Sistêmica e Xerostomia Auto-Reporada entre Residentes em Instituições de Longa Permanência em Iowa-EUA e São Paulo-Brasil

Objective: To describe and compare potential differences in systemic health characteristics and xerostomia among residents in American and Brazilian nursing facilities (NF). Material and Methods: This secondary analysis used data from a study in NF located in Iowa-USA (n=81) and Sao Paulo (SP)-Brazil (n=119). Recorded data included demographics, medications, comorbid conditions, and self-reported xerostomia. Results: The Iowa group mean age was 82.1 years (±12.9), 60.5% were females, and 100% were white, whereas the SP group mean age was 76.4 years (±8.7), 47.9% females, most participants identified as either white (42.0%) or as more than one race (45.4%). The median number of comorbid conditions and medications in the Iowa were 9 and 12, respectively, as compared to 2 and 6 in SP. Most common comorbidities in Iowa were hypertension, dementia (including Alzheimer), and depression. In SP, they were hypertension, unspecified diabetes mellitus (including type 2), and Parkinson. Most common prescription medications in Iowa were acetaminophen, acetylsalicylic acid, and magnesium hydroxide, while in SP, they were omeprazole, acetylsalicylic acid, and losartan. Xerostomia was reported by 32.1% (Iowa) and 59.7% (SP) of the participants. There was no association between age and dry mouth sensation in either Iowa (p=0.480) or SP (p=0.130) samples. However, there was an association between total medications and dry mouth sensation in Iowa (p=0.040), but not in SP (p=0.075) Conclusions: Iowans presented with higher numbers of comorbidities and prescription medications, however xerostomia was reported in a greater percentage in SP. Xerostomia was associated to higher number of medications in Iowa, but not in SP.(AU)

Objetivo: Descrever e comparar possíveis diferenças nas características de saúde sistêmica e xerostomia entre residentes em instituições de longa permanência (ILP) americanas e brasileiras. Materiais e Métodos: Esta análise utilizou dados de um estudo em ILPs localizadas em Iowa/EUA (n = 81) e São Paulo/Brasil (n = 119). Os dados avaliados incluíram dados demográficos, medicamentos, comorbidades e xerostomia autoreportada. Resultados: A idade média do grupo de Iowa foi de 82,1 anos (± 12,9), 60,5% eram do sexo feminino e 100% eram brancos, enquanto a idade média do grupo SP foi de 76,4 anos (± 8,7), 47,9% do sexo feminino, a maioria dos participantes identificados como brancos ( 42,0%) ou como mais de uma raça (45,4%). A média do número de comorbidades e medicamentos em Iowa foi de 9 e 12, respectivamente, em comparação com 2 e 6 em SP. Comorbidades mais comuns em Iowa foram hipertensão, demência (incluindo Alzheimer) e depressão. Em SP, foram hipertensão, diabetes mellitus (incluindo o tipo 2) e Parkinson. Os medicamentos de prescrição mais comuns em Iowa eram acetaminofeno, ácido acetilsalicílico e hidróxido de magnésio, enquanto em SP, foram omeprazol, ácido acetilsalicílico e losartana. A xerostomia foi reportada por 32,1% dos participantes em Iowa e 59,7% em SP. Não houve associação entre idade e sensação de boca seca nas amostras de Iowa (p = 0,480) ou SP (p = 0,130). No entanto, houve associação entre o total de medicamentos e a sensação de boca seca em Iowa (p= 0,040), mas não em SP (p = 0,075). Conclusões: Os residentes de Iowa apresentaram maior número de comorbidades e prescrição de medicamentos, porém a xerostomia foi relatada em maior percentual em SP. A xerostomia foi associada ao maior número de medicamentos em Iowa, mas não em SP.(AU)

Xerostomia em pacientes com HIV/ Aids: revisão sistemática de literatura

Introdução: a transmissão do vírus da imunodeficiênciahumana (HIV) leva à redução da resposta imunológicado indivíduo, podendo ocorrer alterações na cavidadebucal, entre elas, a xerostomia. Objetivo: por meio deuma revisão sistemática, este trabalho objetiva analisara presença e as correlações da presença de xerostomiaem pacientes HIV positivos ou com Aids. Métodos: foifeita busca nas bases de dados PubMed, SciELO e Lilacsutilizando os descritores "oral manifestations", "HIV","Aids" e "xerostomia", sendo os critérios de inclusãotrabalhos epidemiológicos descritivos e observacionaiscom no máximo 10 anos de publicação e em línguainglesa, portuguesa ou espanhola. Resultados: foramencontrados 162 artigos que, após critérios exclusivos,foram reduzidos a 15 trabalhos desenvolvidos em setepaíses, nos quais se encontraram valores variando entre2% e 76,2% na presença de xerostomia em pacientescom HIV/Aids, a maioria homens entre a terceira e aquarta década de vida. Conclusão: a xerostomia em pacientescom HIV/Aids necessita de diversas pesquisasclínicas, devido aos inúmeros fatores que podem ocasionara etiologia, além da grande divergência de resultadosencontrados. Estudos afirmam que patologias queacometem as glândulas salivares podem levar à sensaçãode boca seca nesses indivíduos e são decorrentesda utilização prolongada da terapia antirretroviral altamenteativa (Haart). (AU)

Introduction: the human immunodeficiency virus transmission reduces the immune response of individuals and may cause changes in the oral cavity, such as xerostomia. Objective: by means of a systematic review, the present study aims to analyze the presence and correlations of the presence of xerostomia in HIV+ patients or those living with AIDS. Methods: the databases PubMed, SciELO, and Lilacs were searched using the descriptors "oral manifestations", "HIV", "AIDS", and "xerostomia". Inclusion criteria consisted of observational descriptive epidemiological studies with up to 10 years of publication, in English, Portuguese, or Spanish. Results: a total of 162 articles were found, which after exclusive criteria were reduced to the quantity of 15 studies from seven countries. These studies found varying values in the presence of xerostomia in HIV/ AIDS patients, ranging from 2% to 76.2%, most of them in men between the third and fourth decades of life. Conclusion: xerostomia in HIV/AIDS patients requires several clinical studies due to the numerous factors that may cause the etiology, besides the great divergence of results found. Studies indicate that pathologies affecting the salivary glands may cause dry mouth sensation in these patients, which derives from the prolonged use of Highly Active Antiretroviral Therapy (HAART). (AU)

Condição periodontal e hipertensão arterial em pacientes obesos mórbidos antes e após a cirurgia bariátrica: estudo de coorte prospectivo / Periodontal condition and arterial hypertension in morbidly obese patients before and after bariatric surgery: prospective cohort study

A hipertensão e a obesidade têm sido descritas como graves problemas de saúde pública, tendo uma prevalência de obesidade no Brasil de 20%. Além de causar problemas sistêmicos, a hipertensão e a obesidade podem afetar as condições bucais. Diante disso, o objetivo deste estudo foi identificar doença periodontal em indivíduos obesos hipertensos e não hipertensos, no pré e pós-cirurgia bariátrica (CB), com seguimento de 12 meses. A amostra foi composta por 70 indivíduos distribuídos em dois grupos: grupo obeso com hipertensão (G01=35) e grupo obeso sem hipertensão (G02=35), ambos os grupos foram avaliados no pré e pós cirurgia bariátrica. A avaliação antropométrica dos indivíduos foi realizada através do IMC e circunferência da cintura. O sangramento a sondagem foi realizado por meio do índice de sangramento gengival, da profundidade de sondagem e do nível de inserção clínica e recessão gengival. Foi analisado o fluxo salivar não estimulado e estimulado para mensurar o volume (mL/min). Foram adotados os testes de Kruskal- Wallis, Mann-Whitney, Qui-quadrado e Exato de Fisher (p<0,05). O gênero feminino foi o mais prevalente na amostra avaliada, em ambos os grupos avaliados (G01=85,3%; G02=80%). O modelo ajustado utilizando regressão logística mostrou que apenas a idade (p<0,0001) e a recessão gengival (p=0,0320) foram determinantes na diferença entre os hipertensos e não hipertensos. O período de 12 meses (p=0,913), sexo (p=0,608), IMC (p=0,412), RCQ (p=0,577), profundidade média de bolsa (p=0,114), recessão máxima (p=0,236), escore de recessão (p=0,319), nível de inserção periodontal (p=0,486), escore de nível de inserção periodontal (p=0,074), cálculo (p=0,745), sangramento (p=0,172), fluxo salivar não estimulado (p=0,980), fluxo salivar estimulado (p=0,964) e escolaridade (p=0,448), não foram significativos. Concluiu-se que indivíduos obesos mórbidos com hipertensão arterial apresentam pior condição periodontal e que a CB não interferiu negativamente na saúde periodontal, dentro de cada grupo.(AU)

Hypertension and obesity have been described as serious public health problems as they have increased in alarming proportions both globally and nationally, with a prevalence of obesity in Brazil of 20%. In addition to causing systemic problems, hypertension and obesity can affect oral conditions. Therefore, the objective of this study was to identify periodontal disease in hypertensive and non-hypertensive obese individuals, before and after bariatric surgery (CB), with a follow-up of 12 months. The sample consisted of 70 individuals divided into two groups: obese group with hypertension (G01 = 35) and obese group without hypertension (G02 = 35), both groups were evaluated before and after bariatric surgery. The anthropometric evaluation of the individuals was performed through BMI and waist circumference. Bleeding was performed by means of gingival bleeding index, depth of probing and level of clinical insertion and gingival recession. The non-stimulated and stimulated salivary flow was analyzed to measure the volume (mL / min). The Kruskal-Wallis, Mann-Whitney, Chi-square and Fisher Exact tests were used (p <0.05). The female gender was the most prevalent in the sample evaluated, in both groups (G01 = 85.3%, G02 = 80%). The adjusted model using logistic regression showed that only age (p <0.0001) and gingival recession (p = 0.0320) were determinants of the difference between hypertensive and non-hypertensive individuals. (P = 0.368), mean BMI (p = 0,412), BMI (p = 0,412), WHR (p = 0.577), mean bursal depth (p = 0,114), maximum recession (P = 0.745), bleeding (p = 0,172), non-stimulated salivary flow (p = 0,319), periodontal insertion level (p = 0,419), periodontal insertion level P = 0.980), stimulated salivary flow (p = 0.964) and schooling (p = 0.448), were not significant. It was concluded that morbidly obese individuals with arterial hypertension present worse periodontal conditions and that CB did not negatively affect periodontal health within each group.(AU)

Avaliação do grau de conhecimento sobre xerostomia em estudantes de graduação do curso de odontologia / Knowledge of the degree of evaluation about xerostomia in undergraduate students of dentistry

A xerostomia é uma alteração da saliva que causa sensação de ressecamento bucal, devido à produção di¬minuída de saliva. Dentre os fatores etiológicos, estão: a hipofunção das glândulas salivares, a ingestão de medicamentos, tratamento de radioterapia na região de cabeça e pescoço, stress, alcoolismo, fumo, emoções constantes, síndrome de Sjögren, dentre outras. Esta pesquisa teve como objetivo avaliar o grau de conheci¬mento sobre xerostomia dos alunos do último ano de graduação do curso de Odontologia do Centro Uni¬versitário de João Pessoa (UNIPÊ), João Pessoa, Paraíba, Brasil. Caracteriza-se em um estudo quantitativo, exploratório e descritivo. Foram incluídos alunos de ambos os gêneros, maiores de 18 anos de idade, perten¬centes ao último ano do curso de graduação em Odontologia. O universo e amostra foram compostos por 62 alunos sendo 31 do gênero masculino (50%) e 31 do gênero feminino (50%). Observou-se que no questionário 100% dos alunos definiram corretamente a xerostomia. A maioria dos alunos conhecem as características da saliva e da xerostomia (91,4% e 87,9%, respectivamente), e 85,5% souberam indicar o correto tratamento da xerostomia. Diante dos resultados, conclui-se que foi satisfatório o grau de conhecimento dos alunos do último ano do curso de graduação em Odontologia sobre xerostomia

Among the etiological factors are: salivary glands hypofuntion, drugs ingestion, radiation treatment in the head and neck, stress, alcoholism, smoking, constant emotions, Sjögren's syndrome, among others. This research aimed to evaluate the degree of knowledge about xerostomia of undergraduate students from the last year of the dentistry course at Centro Universitário de João Pessoa (UNIPÊ), João Pessoa, Paraíba, Brazil. It is character¬ized in a quantitative, exploratory and descriptive study. Students from both genders were included, older than 18 years old, and belonging to the last year of the dentistry degree course. The universe and the sample was composed of 62 students, 31 male (50%) and 31 females (50%). It was noted that in the questionnaire, 100% of them correctly defined xerostomia. Most students know the characteristics of saliva and dry mouth (91.4% and 87.9%, respectively), and 85.5% could indicate the correct treatment of xerostomia. Given the results, it was concluded that the knowledge level of the last year students in the dentistry degree course about xerostomia was satisfactory

Aspectos relevantes da síndrome de Sjõgren para o cirurgião-dentista / Sjogren’s syndrome’s relevant aspects for the dental surgeon

A síndrome de Sjõgren (SS), conhecida como síndrome sicca, é uma doença autoimune caracterizada pela hipofunção das glândulas salivares e lacrimais, cuja prevalência na população mundial é de aproximadamente 0,5% a 1%. Por ser uma doença autoimune complexa e de difícil diagnóstico, é sub-diagnosticada e sub-tratada segundo o consenso realizado em 2012 pelo Colégio Americano de Reumatologia (ACR). O Cirurgião-Dentista pode desempenhar papel importante na detecção de possíveis alterações compatíveis com a síndrome, além de auxiliar no tratamento de diversas patologias orais decorrentes da síndrome. Este trabalho tem como objetivo explanar aspectos importantes referentes ao diagnóstico e tratamento da síndrome aqui discutida. A SS apesar de ser considerada uma doença de evolução lenta, em estágios avançados pode ser fatal, principalmente por aumentar as chances dos pacientes virem a desenvolver linfoma não Hodking. O tratamento odontológico dos pacientes com SS deve principalmente ser profilático, com a recomendação do uso de repositores de saliva e controle rígido da higiene bucal.

Sjogren’s syndrome (SS), known as the sicca syndrome, is an autoimmune disease characterized by salivary and lacrimal glands hypofunction which prevalence in the world population is approximatel y around 0,5% to 1%. For being a complex autoimmune disease and with difficult diagnosis, it is sub diagnosed and miss treated according to the consensus occurred in 2012 by the American College of Rheumatology (ACR). The surgeon-dentist (SD) may play a important role on the detection of possible changes compatible to the syndrome, besides can help in the treatment of many oral pathologies caused by the syndrome. This work has the main purpose to explain the important aspects regards to the correct diagnosis and treatment of this syndrome.The SS besides been considered a slow evolution disease, in advanced stages it can be fatal,mainly for increasing the patient’s chances of developing non-Hodking lymphoma. The dental treatment of patients with SS must be prophylactic, with the recomedations of the use of salivary replenishing and careful control of the oral hyigiene.