In the article “The spectrum of orofacial manifestations in systemic sclerosis: a challenging management” (Jung, Martin, Schmittbuhl, & Huck, 2017), the authors have provided an excellent review drawing attention to the impact of the manifestations in the orofacial region of systemic sclerosis (SSc), a multisystem connective tissue disorder disease of a not well-known origin. We thank and congratulate the authors who pointed, in a concise and well-detailed report, the many issues related to this progressively high-profile disease. The findings by Jung et al. (2017) outlined in their review concur with several cases of evidence on this topic that support a wide array of oral manifestation (Del Rosso & Maddali-Bongi, 2014; Matarese et al., 2016) clearly associated with a significant impairment during SSc. These include dental (decayed, filled and missing teeth), periodontal and orofacial (microstomia, xerostomia and alveolar bone resorption) abnormalities (Amin et al., 2011; Cutroneo et al., 2012; Matarese et al., 2015). Within the last few years, several reports have demonstrated the systemic impairment that determines a lower quality of life in SSc patients (Baron et al., 2015). Moreover, it was clearly shown that this systemic impairment is strongly sustained by the handicap due to orofacial disabilities (Baron et al., 2014). All of increasing evidence has stimulated scientists and clinicians to develop a supporting network called “The Canadian systemic sclerosis oral health study” (Baron et al., 2014). This group aims to study the oral abnormalities and oral health-related quality of life (HRQoL) in a large sample of SSc subjects compared to the general population by analysing the data present in the Canadian Scleroderma Research Group (CSRG) registry. In the last few years, several questionnaires have been developed to specifically measure and assess the impact of oral impairment on the global burden of the SSc, such as the Mouth Handicap in Systemic Sclerosis Scale (MHISS) that was also translated into several languages (Mouthon et al., 2007) and the oral HRQoL (Baron et al., 2015). For these reasons, it now appears imperative, with the research that has led to remarkable advances in the prevention and treatment of oral impairment during SSc, to articulate a closer and more robust engagement network across different medical specialities (rheumatology, internal medicine, speech therapy, dentistry and other medical sectors). This would enable the adoption of an upstream method that integrates action on oral health with useful approaches to reduce the global burden of SSc disease in general. This call to action is aimed to focus more attention on the prevention of oral health disabilities in SSc patients before irreversible damage has occurred. Only a balanced and biological approach will be the best route for the appropriate maintenance and the preservation of oral health in these patients. Along with the assessment of specific patient-level factors (risk factor and attitudes), that should help to determine a proper selection of the most appropriate type of professional preventive care as soon as the first orofacial manifestation during SSc occurs. It is to be hoped that all clinicians, from all disciplines that comprise the oral and systemic health providers for SSc, will adopt this approach and become actively involved in this challenge.

New challenge in the systemic sclerosis disease management: A call to action

Gaetano Isola
Writing – Review & Editing
;
2017

Abstract

In the article “The spectrum of orofacial manifestations in systemic sclerosis: a challenging management” (Jung, Martin, Schmittbuhl, & Huck, 2017), the authors have provided an excellent review drawing attention to the impact of the manifestations in the orofacial region of systemic sclerosis (SSc), a multisystem connective tissue disorder disease of a not well-known origin. We thank and congratulate the authors who pointed, in a concise and well-detailed report, the many issues related to this progressively high-profile disease. The findings by Jung et al. (2017) outlined in their review concur with several cases of evidence on this topic that support a wide array of oral manifestation (Del Rosso & Maddali-Bongi, 2014; Matarese et al., 2016) clearly associated with a significant impairment during SSc. These include dental (decayed, filled and missing teeth), periodontal and orofacial (microstomia, xerostomia and alveolar bone resorption) abnormalities (Amin et al., 2011; Cutroneo et al., 2012; Matarese et al., 2015). Within the last few years, several reports have demonstrated the systemic impairment that determines a lower quality of life in SSc patients (Baron et al., 2015). Moreover, it was clearly shown that this systemic impairment is strongly sustained by the handicap due to orofacial disabilities (Baron et al., 2014). All of increasing evidence has stimulated scientists and clinicians to develop a supporting network called “The Canadian systemic sclerosis oral health study” (Baron et al., 2014). This group aims to study the oral abnormalities and oral health-related quality of life (HRQoL) in a large sample of SSc subjects compared to the general population by analysing the data present in the Canadian Scleroderma Research Group (CSRG) registry. In the last few years, several questionnaires have been developed to specifically measure and assess the impact of oral impairment on the global burden of the SSc, such as the Mouth Handicap in Systemic Sclerosis Scale (MHISS) that was also translated into several languages (Mouthon et al., 2007) and the oral HRQoL (Baron et al., 2015). For these reasons, it now appears imperative, with the research that has led to remarkable advances in the prevention and treatment of oral impairment during SSc, to articulate a closer and more robust engagement network across different medical specialities (rheumatology, internal medicine, speech therapy, dentistry and other medical sectors). This would enable the adoption of an upstream method that integrates action on oral health with useful approaches to reduce the global burden of SSc disease in general. This call to action is aimed to focus more attention on the prevention of oral health disabilities in SSc patients before irreversible damage has occurred. Only a balanced and biological approach will be the best route for the appropriate maintenance and the preservation of oral health in these patients. Along with the assessment of specific patient-level factors (risk factor and attitudes), that should help to determine a proper selection of the most appropriate type of professional preventive care as soon as the first orofacial manifestation during SSc occurs. It is to be hoped that all clinicians, from all disciplines that comprise the oral and systemic health providers for SSc, will adopt this approach and become actively involved in this challenge.
Humans; Scleroderma, Systemic; Otorhinolaryngology2734 Pathology and Forensic Medicine; Dentistry (all)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/346951
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