{
  "abstract": "Introduction Systemic sclerosis (SSc) is a rare connective tissue disorder that can significantly impact oral health. Microstomia and reduced salivary flow impair oral hygiene, increasing susceptibility to dental caries and periodontal disease. Despite these complications, data on oral health in Portuguese SSc patients remains limited. This study aimed to assess the burden of impaired oral health in a Portuguese SSc cohort using real-world data.Material and Methods A retrospective observational study included adult SSc patients registered in Reuma.pt. Variables assessed were dental caries, periodontal disease, previous antibiotic therapy for oral infections, dental procedures, frequency of dental appointments, microstomia, and dryness-related syndromes (xerostomia and/or xerophthalmia). Depending on distribution, independent samples t-test or Mann-Whitney U test were applied. For categorical variables, Chi-square or Fisher’s Exact tests were used. A p-value <0.05 was considered statistically significant.Results Seventy-nine patients were included, 71 (89.9%) female, mean age 57.4 ± 1.3 years, with median disease duration of 7.94 years (IQR 7.78). Dental caries were reported in 42 (52.5%) patients, with 9 (11.3%) having 5 or more caries. Periodontal disease was observed in 27 (33.8%), and 17 (21.3%) reported previous antibiotic therapy for oral infections. Frequent dental appointments (2 or more per year) were reported in 28 patients (35%). Microstomia was present in 34 (42.5%), and dryness-related syndromes were reported in 28 patients; 5 (6.3%) had associated Sjögren’s syndrome.Statistically significant associations were found between number of dental caries and microstomia (p=0.003), as well as dryness-related symptoms (p=0.018). Statistically significant associations were also observed between xerostomia, microstomia, and disease duration (p=0.049). No significant association was found between microstomia and periodontal disease (p=0.8).Conclusions Our findings highlight a significant burden of oral disease in SSc patients, particularly the association of microstomia and xerostomia with higher numbers of dental caries. These results align with previous evidence that salivary dysfunction and restricted mouth opening compromise oral hygiene. Compared with the general Portuguese population, where caries prevalence is already high, SSc appears to exacerbate oral disease burden. Although few patients had associated Sjögren’s syndrome, future studies should investigate oral health outcomes in larger populations and further explore the potential role of periodontal disease in amplifying systemic inflammation in SSc. Targeted preventive measures, such as oral physiotherapy to improve mouth opening and orofacial mobility, regular dental monitoring, and multidisciplinary care are warranted to mitigate oral complications in these patients.",
  "authors": [
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Ana Da Rocha Sá"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Carlos Marques Gomes"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Mariana Diz Lopes"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Bárbara Esteves"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal",
        "Hospital Divino Espírito Santo - Rheumatology Department, Ponta Delgada, Portugal"
      ],
      "name": "Marina Oliveira"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Miguel Natal"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Sara Helena Amaro Lopes"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Salomé Garcia"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Georgina Terroso"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Lúcia Costa"
    },
    {
      "affiliations": [
        "ULS São João - Rheumatology Department, Porto, Portugal"
      ],
      "name": "Raquel Miriam Ferreira"
    }
  ],
  "title": "P.404 The hidden impact of systemic sclerosis in oral health: evidence from a Portuguese population",
  "uid": "d85a6061-adcf-563c-b2ba-37a1cd3f1ba0"
}