Oral health and dental care challenges in scleroderma - perspectives of dentists, rheumatologists, and patients

Objectives

The oral health care challenges of people living with scleroderma (systemic sclerosis—SSc) are poorly understood, yet frequently reported. This mixed methods study aimed to investigate oral health and dental care challenges associated with SSc from the perspective of dentists, rheumatologists, and patients.

Methods

Dentists, rheumatologists, and SSc patients in the UK completed a survey about their experiences of oral health, dental care, and quality of life. People with SSc were also interviewed. We conducted descriptive analysis of quantitative data and used thematic analysis to examine qualitative data.

Quant Results

Quantitative: 95.5% of patients reported oral and dental manifestations of scleroderma (ODMS); 57.1% reported high physical impacts, 53.8% high psychological impacts, and 47.7% high social impacts. Only 13% of patients were informed of ODMS at diagnosis. No dentist or rheumatologist felt fully confident in managing ODMS. The most frequent suggestion for improvement among patients and dentists was increased information for dentists. Qualitative: We identified 3 key themes. 1) Significant negative impact on quality of life; 2) Barriers to accessing dental care; 3) Characteristics of good dental care.

Conclusion

ODMS are prevalent issues, constituting a significant burden on quality of life. Rheumatologists should inform SSc patients of ODMS and embed oral health inquiries into annual reviews. Communication between medical and dental practitioners should be encouraged to facilitate early identification and management of ODMS.