How autoimmune conditions affect your oral health

More than 24 million Americans (about 7% of the population) have some form of autoimmune condition, and the prevalence is rising, according to the National Institutes of Health. There are more than 80 different types of autoimmune conditions.

Autoimmune conditions affect your overall health, and they impact your dental health, too. Here’s what you need to know about your oral health if you have an autoimmune condition.
 

What is an autoimmune condition?

Your immune system helps your body stay healthy by fighting off invading microorganisms. But sometimes, the immune system starts attacking healthy cells and tissues. An autoimmune condition arises from this abnormal response to an otherwise healthy body part. Most autoimmune conditions cause inflammation, which produces redness, heat, pain and swelling.

There are many different autoimmune conditions, and the symptoms they cause can vary greatly depending on the body part or parts affected. Some autoimmune conditions involve only one type of tissue; others involve many different parts of the body.  For example, vasculitis primarily affects the blood vessels. Lupus, on the other hand, can damage the skin, heart, lungs and more. 
 

What causes an autoimmune condition?

Researchers still don’t know what causes most autoimmune conditions. Some have theorized that a combination of factors, including environmental or chemical triggers, diet, infections or drugs, trigger changes that confuse the immune system.

Certain people may be more prone to developing autoimmune conditions due to genetics. Women get autoimmune conditions at a rate of about two to one compared to men. Some autoimmune conditions affect certain ethnic groups more than others. For instance, lupus has a significantly higher prevalence among African Americans compared with Americans of European descent.
 

How do autoimmune conditions affect your mouth?

Having an autoimmune condition can make you more susceptible to a number of oral health conditions, including:
 

• Tooth decay. Many autoimmune conditions result in a decrease in saliva if the immune system attacks the salivary glands. Saliva helps to rinse the teeth and control bacteria population in the mouth, so less of it means you’re more prone to tooth decay.
• Gum disease. Autoimmune conditions can also lower your body’s natural defenses against infection, making gums more susceptible to gingivitis and gum disease. Diabetes and gum disease are also linked, likely due to increased sugar levels in saliva, which allow bacteria to thrive. Gum disease can, in turn, make it more difficult for diabetic patients to manage their blood sugar levels.
• TMJ disorder. Some autoimmune disorders like rheumatoid arthritis directly affect the joints. Temporomandibular joint (TMJ) disorder occurs when the hinge joint of the lower jaw becomes inflamed, causing pain and restricted movement.
• Mouth ulcers. Autoimmune conditions like lupus and Crohn’s disease can cause ulcers to develop more easily on the soft tissues of the mouth.
• Blood vessel and nerve damage. Some autoimmune conditions cause damage to the blood vessels and nerves, which include those in the mouth. The support structure for the teeth can start to deteriorate. Nerve damage can also mean that you are unable to feel pain that would otherwise indicate a problem, so you may not be aware that anything is wrong as the damage is happening.
   

Which autoimmune conditions affect oral health?

Autoimmune conditions affect systemic health, and oral health is part of systemic health. Many autoimmune conditions, both common and rare, impact the health of your mouth.

Here are a few which are specifically known to adversely affect the oral cavity:
 

Sjögren’s syndrome

Because the condition attacks the salivary glands and leads to a dry mouth, Sjögren’s syndrome causes an increased risk for cavities, gum disease and ulcers. 
 

Lichen planus

Lichen planus is an autoimmune disorder affecting the skin and mucous membranes which line the inside of the mouth, nose, eyes and other sensitive areas of the bodies. Lichen planus can cause painful burning or stinging inside the mouth. White patches or lines may appear on the inner cheeks, and eating and drinking can become uncomfortable.
 

Pemphigus vulgaris and bullous pemphigoid

These two disorders cause similar problems in the mouth.  Most patients with pemphigus vulgaris develop lesions inside the mouth, and in many cases, the oral lesions are the first sign of the condition. Both pemphigus vulgaris and pemphigoid cause painful blisters, which can burst leaving large ulcers.
 

Celiac disease

For those with celiac disease, eating gluten (a prominent ingredient in the flour typically used to make breads, pasta, cakes and cookies) can cause an inflammatory response.

Celiac disease affects the formation of tooth enamel, and problems can include tooth discoloration — white, yellow, or brown spots on the teeth — poor enamel formation, pitting or banding of teeth and mottled or translucent-looking teeth.

Those with celiac disease typically suffer from dry mouth and ulcers.

Celiac disease can also affect the body’s ability to absorb nutrients and heal, which may result in longer than normal healing times from dental surgeries or oral injuries and a worsening of gum disease.
 

Diabetes

Diabetes affects about 37.3 million Americans. If left untreated, it can have disastrous effects on the health of your mouth. If you have diabetes, you are more prone to have dry mouth and gum disease that does not respond well to treatment. 

Gum disease is the most common and serious oral health problem linked to diabetes: Uncontrolled blood sugar makes it more difficult to control gum disease, and uncontrolled gum disease causes spikes in blood sugar. If you have diabetes, you may experience more mouth infections, as well as burning mouth syndrome.  
 

How do you take care of your oral health with an autoimmune condition?

If you’re living with an autoimmune condition, your dentist is a crucial part of your medical care team. Maintain a strong dental routine at home, stay hydrated to combat dry mouth and follow your physician’s recommendations regarding diet and other lifestyle habits.

To find out more, learn these four steps to taking care of your oral health with an autoimmune condition.

Last updated December 1, 2022