Autoimmune Disorders 101: How Autoimmune Diseases Can Affect Oral Health

Your immune system defends your body from invading microorganisms such as bacteria and viruses, which cause illnesses. According to the Autoimmune Association, an immune response can’t be triggered by the cells in your body—but sometimes, immune cells mistakenly attack the cells that they’re meant to protect, which leads to autoimmune diseases. There are two types of common autoimmune diseases: organ-specific, in which the autoimmune process occurs in just one organ (like type 1 diabetes and pernicious anemia), and non-organ-specific, where autoimmune activity happens all over the body (like rheumatoid arthritis and lupus). There are over 100 autoimmune disorders that affect more than 24 million people, and disorders are more common in women. So if you have an autoimmune disease, you’re not alone.

How do autoimmune diseases affect oral health? First, it’s important to step back and realize oral health is closely linked to systemic health, and therefore, manifestations of autoimmune disease. According to scientists at the Sapienza University of Rome, the mouth could be where an autoimmune disease first manifests. Next, we'll look into some autoimmune diseases and signs and symptoms found in the oral cavity.

Oral manifestations of autoimmune disease often occur. Some examples include the following:

• Systemic Lupus Erythematosus (SLE): SLE, according to the National Resource Center on Lupus, is a chronic inflammatory autoimmune disease that affects your body's organs or organ systems. SLE can cause serious complications like inflammation of the kidneys, nervous system and brain, skin, and hardening of the arteries and blood vessels. The symptoms in the mouth may include oral discoid lesions. Gingivitis may also occur.
  
  
• Sjögren Syndrome: This systemic autoimmune disease, according to the Sjögren's Foundation, affects the entire body. Symptoms range from extensive dryness to other serious complications like chronic pain and extreme fatigue. When it comes to oral manifestations, Sjögren Syndrome affects the salivary and lacrimal glands (tear glands) and reduces your body’s ability to create saliva, which causes dryness in the mouth, according to the American Dental Association. Thus, cavities due to dry mouth are the most common complications, creating a more favorable environment for plaque to thrive.
  
  
• Pemphigus: According to Johns Hopkins Medicine, this rare group of autoimmune diseases is characterized by blisters in the outer layer of the skin and the mucous membranes. This disease usually starts with blister formations in the mouth, esophagus, or on the scalp, which are soft and easily broken—and may be painful but not itchy. These blisters in your mouth or throat may make it hard to swallow and eat.
  
  
• Behcet Disease: According to the Mayo Clinic, this rare disorder causes blood vessel inflammation throughout your body. Painful mouth sores that look like canker sores are a prominent inflammatory symptom. They begin as raised, round lesions that turn into painful ulcers and heal in one to three weeks.
  
  
• Crohn's Disease: While Crohn's is an inflammatory bowel disease, redness, swelling, and sores can appear in your digestive system and your mouth. According to Crohn’s and Colitis Canada, ​​these lesions are small, shallow, round or oval, and painful. They generally heal in about two to six weeks.
  
  
• Oral Lichen Planus: This oral autoimmune disease occurs when the immune system attacks the mucous membranes inside your mouth, according to The Mayo Clinic. It will appear as lacy white patches, sometimes accompanied by painful sores on the lining of the cheeks, tongue, and gums.