Getting to know lupus

Causes and symptoms

It is not yet fully understood what causes lupus – medically known as systemic lupus erythematosus. It has been linked to various potential sources including viral infections, certain medications, sunlight, puberty, childbirth and menopause, though the exact mechanisms are not known.[i]

It most commonly affects women, who are nine times more likely to suffer than men. Those aged 15-45 years are typically most at risk. Symptoms vary between individuals and may include:[ii]

Arthritis
Fever
Fatigue
A rash on the face
Sensitivity to the sun
Hair loss
Change of colour in the fingers and toes
Swelling in the legs or around the eyes
Pain when breathing deeply or lying down
Headaches, dizziness, or confusion
Abdominal pain

There are also several oral symptoms associated with lupus. These are:

Swollen salivary and lymph glands
Sores, usually painless, in the nose and mouth

Of course, these alone can be a sign of many different things, so it’s important to ask patients broader questions. Where multiple symptoms are identified and lupus suspected, they should be signposted for a medical screening.

When the condition is left untreated it can lead to more significant problems for sufferers. These include kidney damage, seizures and memory problems, heart problems, vasculitis (inflammation of the blood vessels) and blood clots, among other concerns. Those with lupus are also more likely to develop atherosclerosis and coronary artery disease.

Management techniques

Although there is no cure for lupus, symptoms can typically be managed effectively. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine, corticosteroids, immunosupressants, rituximab and belimumab may be administrated. Unfortunately, some of these are associated with negative side effects that affect the mouth. For example, corticosteroids can reduce bone health, while immunosuppressants can cause swollen gingivae.

It is also generally recommended that those diagnosed with lupus avoid prolonged sun exposure. Covering the skin and using high SPF to prevent sunburn are beneficial for many sufferers. In some situations, vitamin D consumption should be optimised trough diet or supplements to prevent increasing the risk of osteoporosis.[iii]

Part of the support network

Ultimately, there is little dental professionals can do to help patients prevent lupus. Our role is more about helping those with a diagnosis to alleviate any oral symptoms they might be experiencing. For more information about lupus and how to support those diagnosed, you can visit the Lupus UK website.

[i] NHS. Lupus. https://www.nhs.uk/conditions/lupus/ [Accessed September 2024]

[ii] National Institute of Arthritis and Musculoskeletal and Skin diseases

[iii] NHS Inform. Lupus. https://www.nhsinform.scot/illnesses-and-conditions/immune-system/lupus#treating-lupus [Accessed September 2024]