Scleroderma patients often suffer from a dry mouth. According to the Scleroderma Foundation, 300,000 cases of scleroderma are estimated in the United States. Eighty percent of scleroderma patients are female, the disease typically strikes between the ages of 25 and 55. (Photo: Dan Kosmayer/Shutterstock)

Jun 10, 2014 | News Americas

MEDFORD, Mass., USA: A survey of dentists in Massachusetts suggests that their confidence in treating patients with scleroderma may be related to their familiarity with the autoimmune disease. Dentists who reported feeling knowledgeable about scleroderma felt more prepared to provide care to patients with scleroderma when compared with peers who did not feel as knowledgeable.

Scleroderma, derived from the Greek words for "hard skin," is a group of autoimmune diseases that are characterized by thickened and tightened skin, as well as dry mouth. Patients with scleroderma typically have shrunken mouths and stiffer hands, making it difficult to brush and floss their teeth. They also have difficulty opening their mouths wide, making it difficult to receive oral care and for dentists and dental hygienists to provide care. This may contribute to the higher risk of oral diseases among dental patients who have scleroderma.

An unpublished national survey of 350 scleroderma patients in 2011 by students and faculty at Tufts University School of Dental Medicine found that people with scleroderma have difficulty obtaining professional oral health care.

In order to expand on the results of the unpublished survey, Dr. David Leader, an associate clinical professor at the dental school, and colleagues developed a new survey in an effort to understand dentists' knowledge of scleroderma and their attitudes toward treating patients with the disease.

An online survey was sent to the 4,465 members of the Massachusetts Dental Society, which represents 80 percent of practicing dentists in the state, and was completed by 269 (6 percent) of the dentists. The survey questionnaire examined dentists' knowledge of scleroderma and their confidence in treating or ability to treat patients with scleroderma.

The survey found that the 71 percent of dentists who felt better prepared to treat patients with scleroderma were more likely to be knowledgeable about the indicators of the disease, such as dry mouth, and thickening of the skin. In contrast, 28 percent of the respondents did not feel qualified to treat scleroderma patients, and 51 percent of the respondents were concerned that their lack of knowledge regarding caring for an individual with scleroderma may cause harm to the patient. Additionally, approximately 96 percent of dentists stated that they would like to learn more about scleroderma. The results indicate that awareness of protocols and complications associated with treating patients with scleroderma may help improve their oral health care by professionals.

"In this case, dentists may be overly concerned about their patients' needs, because they feel that they do not know enough to treat someone with scleroderma, and thus fear causing harm. That said, if dentists have access to knowledge about how to accommodate patients with scleroderma, they can confidently provide care," said first author Leader.

The study, titled "A Survey of Dentists' Knowledge and Attitudes With Respect to the Treatment of Scleroderma Patients," was published in the June issue of the Journal of Clinical Rheumatology.