Sjogren's and teeth?

OK, I thought I'd muddy the waters a bit here.

We all know that the dry mouth of Sjogren's syndrome can have a devastating effect on teeth. But have any of us had experience of dental problems bringing on SS?

I've been doing a lot of reading lately on the question of root canal procedures bringing on degenerative diseases and even breast cancer(!) I'm sure most people on here already know the theory behind this but I'll re-state a simplified version anyway. The idea is that it's impossible to sterilise the dead cavity left behind after the nerve is removed, and once it's sealed with a crown, anaerobic bacteria start growing in there, and migrate to the bloodstream.

Now, I had a badly botched root canal on a molar in my lower jaw in 1995, and that was the year my SS symptoms started. I never ceased to have problems with the tooth after that, culminating in a nasty abscess in 2007. I ended up as an emergency in maxillo-facial outpatients over that one. The surgeon who finally removed the tooth and scraped away the infected bone confirmed what I'd long suspected - that the tooth had been broken through the root either before, or during the process of, the root canal. Needless to say, I changed dentists after that.

Later that year, my SS started the slow process of going into a remission that was more or less complete two years later and lasted about six years after that. I'm just recovering now from the first flare-up since then, which has lasted nearly a year. However, this flare-up hasn't been nearly as bad as the original attack of SS. It's tempting to make a connection with the root canal.

However... I'm not totally convinced that that's the whole story. I suspect my SS is secondary (though that's never been confirmed by a doctor) as I had a very severe attack of RA in my mid-30s, 15 years before my first SS symptoms. This came out of the blue, and was seriously disabling while it lasted. It started suddenly in my right hip while I was out walking one day, and within a few weeks had spread to both hips, knees, big toes and hands. For a couple of weeks I could barely get out of bed, and had to be signed off work. I had the great good fortune to be put in touch with a homeopathic rheumatologist (who was a medical doctor too) who cured me with homeopathic remedies and dietary advice. I continue to have occasional problems with my joints, but nothing like that first attack.

But that may also have been tooth-related, albeit not root canal. Six years before the RA attack, and just before I left the UK for good, I had a small filling in an upper molar. I was in severe discomfort afterwards, and could feel a lump on the outside of my gum, just above the tooth, which was clearly a piece of filling that had been shoved up between the tooth and the gum. (I'm afraid I don't seem to be very good at picking dentists!) I went back repeatedly, only to be fobbed off each time, and after a couple of months a large piece of filling duly worked its own way out.

The same year the RA struck, I had the first attack of pain in the badly filled tooth. For the next 10 years I had intermittent attacks of severe toothache and mild sinusitis. I saw five dentists in two different countries during that time, all of whom X-rayed the tooth and could find nothing wrong. Finally, after a severe attack of sinusitis on that side (fever, swollen face, one eye closed, foul-smelling nasal discharge) my doctor referred me to the hospital, where it was discovered that there was a hidden infection in the inside root of the tooth, which isn't visible on a normal X-ray. The tooth was extracted, with great difficulty as it had become ankylosed into the socket by the infection, and a deep curetage of the infected bone performed. I was told I was very lucky the infection hadn't broken through the bone into the maxillary sinus.

Not sure what to deduce from all this - apart from the fact that rubbish dentists exist on both sides of the Channel! - but it's tempting to suspect that most of my auto-immune troubles might have originated in my teeth.

2 likes, 6 replies