A carregar...
Publicação
Cuidados dentários e desafios em pacientes com síndrome de Sjögren: caso clínico
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| Projeto de pós-graduação_41399 | 1.63 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
A síndrome de Sjögren (SS) é uma patologia autoimune crónica com infiltração linfocítica e lesão progressiva das glândulas exócrinas, nomeadamente as glândulas salivares e lacrimais, levando a xerostomia (boca seca) e queratoconjuntivite seca (olhos secos). Encontra-se entre as três doenças auto-imunes mais comuns e ocorre em 0,5-3% da população, com predominância no sexo feminino. Pode também apresentar-se como uma doença sistémica, com envolvimento de órgãos como os rins, os pulmões e o cérebro, e sintomas como fadiga, artralgia e artrite são os mais frequentes e encontrados. O médico dentista tem um papel fundamental no diagnóstico precoce, pois é frequentemente o primeiro profissional a detetar sinais clínicos indicativos da doença. O caso clínico apresentado é de uma paciente adulta, 55 anos, com SS primário diagnosticada em 2021 e que apresentava vários sinais e sintomas da síndrome: sensação constante de secura na boca, dificuldade de mastigação e deglutição, dor na articulação temporomandibular (ATM), dor durante a mastigação, alteração do paladar (disgeusia), sensação de ardor na mucosa oral, halitose, e algumas cáries. Estas manifestações são decorrentes da redução do fluxo salivar, que interfere no equilíbrio da microbiota bucal, na lubrificação e na função protetora da saliva. A ausência de saliva adequada predispõe à formação de lesões de cárie, além do risco de infeções e alterações na ATM, como dor e estalidos durante a mastigação. A paciente torna-se mais suscetível a cáries dentárias e infeções fúngicas, alterações na mucosa lingual e tecido gengival e eventualmente doença periodontal. A integração do exame clínico com instrumentos como o questionário ‘OHIP’ permitiu uma maior compreensão do impacto físico e psicológico da patologia na paciente, permitindo uma comunicação mais eficaz com a mesma e uma intervenção mais adaptada às suas necessidades específicas. Este caso clínico reforça a importância da gestão multidisciplinar da SS, enfatizando o papel fundamental do médico dentista no diagnóstico, acompanhamento e gestão a longo prazo do doente.
Sjögren's syndrome (SS) is a chronic autoimmune disease with lymphocytic infiltration and progressive damage to the exocrine glands, particularly the salivary and lacrimal glands, leading to xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes). It is among the three most common autoimmune diseases and occurs in 0.5-3 per cent of the population, predominantly in women. It can also present as a systemic disease, involving organs such as the kidneys, lungs and brain, and symptoms such as fatigue, arthralgia and arthritis are the most frequent and common. Dentists play a key role in early diagnosis, as they are often the first professionals to detect clinical signs of the disease. The clinical case presented is of a 55-year-old adult patient with primary SS who was diagnosed in 2021 and presented with various signs and symptoms of the syndrome: a constant feeling of dryness in the mouth, difficulty chewing and swallowing, pain in the temporomandibular joint (TMJ), pain during chewing, a change in taste (dysgeusia), a burning sensation in the oral mucosa, halitosis, and some cavities. These manifestations are the result of reduced salivary flow, which interferes with the balance of the oral microbiota, lubrication and the protective function of saliva. The absence of adequate saliva predisposes to the formation of caries lesions, as well as the risk of infections and alterations in the TMJ, such as pain and clicking during chewing. The patient becomes more susceptible to dental caries and fungal infections, alterations in the lingual mucosa and gum tissue and eventually periodontal disease. Integrating the clinical examination with instruments such as the “OHIP” questionnaire allowed for a greater understanding of the physical and psychological impact of the pathology on the patient, allowing for more effective communication with her and an intervention better adapted to her specific needs. This clinical case reinforces the importance of multidisciplinary management of SS, emphasising the fundamental role of the dentist in the diagnosis, follow-up and longterm management of the patient.
Sjögren's syndrome (SS) is a chronic autoimmune disease with lymphocytic infiltration and progressive damage to the exocrine glands, particularly the salivary and lacrimal glands, leading to xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes). It is among the three most common autoimmune diseases and occurs in 0.5-3 per cent of the population, predominantly in women. It can also present as a systemic disease, involving organs such as the kidneys, lungs and brain, and symptoms such as fatigue, arthralgia and arthritis are the most frequent and common. Dentists play a key role in early diagnosis, as they are often the first professionals to detect clinical signs of the disease. The clinical case presented is of a 55-year-old adult patient with primary SS who was diagnosed in 2021 and presented with various signs and symptoms of the syndrome: a constant feeling of dryness in the mouth, difficulty chewing and swallowing, pain in the temporomandibular joint (TMJ), pain during chewing, a change in taste (dysgeusia), a burning sensation in the oral mucosa, halitosis, and some cavities. These manifestations are the result of reduced salivary flow, which interferes with the balance of the oral microbiota, lubrication and the protective function of saliva. The absence of adequate saliva predisposes to the formation of caries lesions, as well as the risk of infections and alterations in the TMJ, such as pain and clicking during chewing. The patient becomes more susceptible to dental caries and fungal infections, alterations in the lingual mucosa and gum tissue and eventually periodontal disease. Integrating the clinical examination with instruments such as the “OHIP” questionnaire allowed for a greater understanding of the physical and psychological impact of the pathology on the patient, allowing for more effective communication with her and an intervention better adapted to her specific needs. This clinical case reinforces the importance of multidisciplinary management of SS, emphasising the fundamental role of the dentist in the diagnosis, follow-up and longterm management of the patient.
Descrição
Palavras-chave
Síndrome de Sjögren Manifestações ora Síndrome de Sjögren primário Saúde oral Sjogren's syndrome Oral manifestations Sjogren's syndrome primary Oral health