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This problem began six months ago but has become more severe over time. She has also noticed small cavitations appearing on some of the root surfaces. Coincidentally, Helen has noticed an increase in dryness in both her mouth and eyes. Her general health is good and she has no other health problems.

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Clinical examination revealed that the exposed root surfaces of the maxillary anterior teeth are affected by erosion and are extremely sensitive to air and thermal stimuli. Toot surface caries lesions are present on the lower anterior teeth.

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Saliva testing revealed an acidic salivary pH, both at rest and when stimulated. She also had depressed salivary buffer capacity. A lifestyle analysis revealed that Helen did not consume either caffeine or alcohol, and had a water intake of more than 2 litres per day. The combination of depressed salivary parameters and ocular dryness in a female patient of this age is suggestive of primary Sjogrens Syndrome. Serological testing and a labial salivary gland biopsy confirmed this presumptive clinical diagnosis.

In the light of her ongoing caries and erosion problems, Helen's home care program included GC Tooth Mousse Plus with Fluoride twice daily, a saliva substitute, and intermittent Dry Mouth Gel Therapy. After restoring her cavitated areas with dental sealant, Helen was then enrolled in a three-monthly maintenance program to ensure regular review of her status and to provide ongoing fluoride varnish applications to the at-risk tooth surfaces.


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