I wish I could offer something...but, they added sjogren's to my list just because I told them that my eyes were dry!!! They gave me the plaquinil and quite frankly...I don't notice anything bad or good. But, that was like, 4 years ago. I just take it because i'm of the mindset...if it ain't broke...don't fix it. Hope all goes well for you!

I've never been officially diagnosed with it, but my eyes are soooo dry all the time and my mouth too. I talked to my eye dr. about it and he told me to use TheraTears brand eye drops and eyelid wash. They do help some especially in the winter months. I don't know much about the dry throat and mouth, but I also use Biotene mouth wash. It's wetting wash or something like that, and it helps a bit with dry mouth. I've been on plaquenil for years and it doesn't touch the dryness. Good luck.
-Kate

You may not think the plaquenil is working but a week or so after you stop taking it, you definately know it was working. I also had the sjorgens added to my ginormous list as well. Oh what the hell, what is one more when you have as many as us :)

Sorry to hear about your additional diagnosis of Sjogren's. I haven't officially been diagnosed with it, but I have all the symptoms.

I strongly recommend joining the Daily Strength Sjogren's group. I have learned so much, especially from a woman who's username is "DryRDH". She is a registered dental hygienist who has Sjogren's and is passionate about helping other "sjogies" take care of their teeth.

I learned the hard way how important it is to adopt a "dry mouth" oral care routine. I had "perfect" teeth my entire life, then had 4 cavities and 2 root canals in the year before I got my MCTD diagnosis because I didn't realize the environment in my mouth had changed. I have included DryRDH's recommendations below.

For dry eyes, I use Systane Ultra drops and warm, wet compresses as needed.

Here are the recommendations that DryRDH wrote in response to another member who was having problems with decay. I couldn't find the original thread, but found it on another forum where I re-posted it:

It really annoys me when patients are allowed to get into trouble when even a Sjogie can prevent decay if they have the right tools and the right information. My last cavity was 1962. Of course being a dental hygienist has some real advantages. My own program includes Evoxac three times a day, a Water Pik (now called WaterFlosser), a Flexcare from Philips (a fancy Sonicare,) and Xylitol therapy (since I've developed allergies to Oral Balance, my favorite oral moisturizer, and everything with Sorbitol and Splenda which includes Biotene, Salese, and pretty much everything I used to use.)

Our protocol for normal non-allergic dry mouth patients includes:
electric toothbrush, Water Pik, Biotene PBF toothpaste or rinse, Oral Balance to moisturize as needed since it lasts longer and give you more relief for your money, fluoride trays for one year if they have active decay and extending until they have been decay-free for 12 months, and MI Paste to buffer acids every 4 hours. .

With dry mouth patients, x-rays more often can catch stuff at an earlier phase. We usually take them yearly until the patient is decay-free for at least a year, then take them every 2 years one they are well maintained.

You need to be using a custom fluoride tray with Prevident 5000 gel every day for 5 minutes. It's the minimum standard of care for uncontrolled decay in a Sjogren's patient according to the Sjogren's Syndrome Handbook. Your dentist should know that the tray method has better success than the brush on stuff.

Act is fine, and the new dry mouth version is soothing, but it's for maintaining once you are decay-free for a year, not for treating active decay. Not that you can't use it too, but you need to have the best treatment right now, and that is the trays.

Sometimes it's hard to manage with different products, so I want to include a general protocol to maximize the benefits of everything you are using. You need to allow at least 20 minutes between each product so the active ingredients can attach to the protein/protection layer around each tooth. For example, if you are using Biotene PBF toothpaste, which I strongly recommend for Sjogies, then wait 20 minutes before using a rinse. If you are using Prevident 5000 Plus, then wait 20 minutes before using Biotene PBF rinse. Both the PBF products have 12 hours plaque-busting enzymes that aren't available in any other product. Sjogies need all the help that they can get. If you brush twice a day with the Prevident 5000 Plus, then use the PBF Biotene midday or buy the rinse and use as I mentioned.

Prevident strengthens exposed tooth surfaces, but doesn't repair any damage that is already there. When you are super dry you may not have enough minerals present to repair damage. I've had super dry patients still lose teeth with Prevident therapy because of the missing minerals. For severe dry mouth patients now, we use a combination of MI Paste (minerals in abundance with bio-available calcium ) and Prevident 5000 Plus, or MI Paste Plus (with fluoride) by having the patient smear it on their teeth and then place the trays to hold it in place for 5 minutes, once a day. The regular MI Paste can be used as often as desired to buffer acids and remineralize (repair) tooth damage before it becomes a cavity.

Xylitol is another tool in the decay prevention tool box. Xylitol starves oral bacteria and makes them less sticky so you can reduce your risk of decay by ingesting 6-10 grams/day. I use compressed Xylitol tablets that I order through a dental supply company. If you don't have a corn allergy, MI Paste and the PBF Biotene are much easier to obtain.

A WaterPik will go a long way to remove up to 99.9% of plaque with a good technique. You need to aim the stream of water just above the gumline, since plaque begins under the gum line. This method will allow the splash to flush out the pocket around the tooth and blast out any bacteria living in the small niche between the crown and the tooth. An ideal crown as a margin defect of about 50 microns. This is really tiny, but the bacteria average about 3 microns, so it's a party for them. Flossing isn't enough to keep those margins clean.

A power toothbrush is so much more effective than hand brushing, that I hardly ever suggest a hand brush to anyone any more. Certainly not to a patient with active decay. Any power toothbrush is better, even the cheapest battery brushes on the market. Most require only half the pressure to clean off plaque, so there is less wear and tear on your dry gums. For an inexpensive brand, Oral B's battery brush at about $15 is a good buy. The round head rotates back and forth 1/4 turn and does a good job of following the curves at the gum line for better efficiency. My Flexcare is the ideal brush since it requires only 1/3 of the hand brushing pressure, but they are expensive and not everyone can manage the cost. If you can though, you'll love it. I used to get canker sores in my mouth from hand brushing pressure. When I switched to a Sonicare back in 1998, they became a distant memory. I think I'm on my fourth Sonicare now, mostly because of newer models and the fact that my daughters beg to have mine when they come home. LOL! I guess they fact that they could buy their own hasn't penetrated their thought process.

I usually give this as a 90 minute lecture, so I hope you can get some useful information from my ramblings.

One more comment: Sjogie can get decay anywhere including the biting edges of front teeth because we are so dry. Hidden cavities can happen to anyone who doesn't have ideal home care. We are much more likely to develop decay on the cheek sides of teeth near the gum line because that side is drier.

Feel free to contact me directly if necessary for some references to use with your dentist!