On Saturday July 15, 2017, U.S. tennis star, 37 year-old Venus Williams lost in the finals of the Women’s Wimbledon Tennis Championship to 23-year old Garbine Muguruza of Spain. Williams was the oldest Wimbledon finalist since 1994 when Martina Navratilova was also a runner-up at the same age. In a young women’s sport, Venus is showing amazing ability, talent and energy, especially considering that she has Sjogren’s Syndrome.
Venus’s last Grand Slam final was in 2009, over seven years ago. Later that year in 2009, Venus Williams, at age 31, pulled out of the U.S. Open after having suffered joint pain, hand swelling, numbness, fatigue, dry eyes and a dry mouth. She had an overall feeling of being “beat up.” Venus was finally diagnosed with Sjogren’s syndrome, a little-known autoimmune disorder.
Sjogren’s (pronounced SHOW-grins) is often misunderstood and misdiagnosed. In 2005, Venus Williams was diagnosed with exercise-induced asthma after having trouble breathing and was given medication that didn’t work. She had been struggling with unclear symptoms until 2009 when it was determined that she had Sjogren’s. At that time on Good Morning America, Williams discussed her experience with Sjorgren’s and cited the disease as the reason she pulled out of the U.S. Open. She also said that she was “thankful to finally have a diagnosis”.
What is Sjorgren’s Syndrome?
Sjogren’s Syndrome [SS] is a chronic disorder in which white blood cells target the body’s moisture-producing glands. Its hallmark symptoms are dry eyes and dry mouth, but Sjogren’s patients also often experience extreme fatigue and joint pain and sometimes problems with other organs or the central nervous system. People with Sjogren’s also have a higher risk of developing lymphoma, particularly in the salivary glands. The condition is named after Henry Sjogren, a Swedish ophthalmologist, who first described the primary clinical features of this disorder in 1933.
Two distinct forms of Sjogren’s syndrome have been recognized:
Primary Sjogren’s syndrome – defined as dry eye and dry mouth that occur by themselves and are not associated with another autoimmune disorder. Primary Sjogren’s syndrome occurs in approximately 50% of cases according to the Sjogren’s Foundation of America.
Secondary Sjogren’s syndrome – characterized by dry eye and dry mouth that occurs in the presence of a major underlying autoimmune connective tissue disease such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma.
It has been estimated that up to 4 million Americans are afflicted with Sjogren’s syndrome. However, because the disorder is difficult to diagnose, the incidence of the disease may be considerably higher. Sjogren’s syndrome affects predominately women rather than men by a ratio of 9:1; however, the symptoms in males and females are the same.
The typical patient is a Caucasian female, usually of Northern European ancestry. Symptoms of the disorder most often begin between the ages of 40-60, predominantly in post menopausal women, but are also seen in young women in their 20s and 30s. The average age of onset is 52 years old. Venus Williams is an example of the range of exceptions. However, SS is probably under diagnosed particularly in black women, who often are misdiagnosed with lupus. On average it takes a person six to seven years to be diagnosed with SS, as symptoms are often mistaken for depression, menopause, even hypochondria.
There is no known cure for Sjögren’s syndrome, nor is there a treatment to restore secretion of moisture by the glands. For the most part, treatment is designed to help relieve symptoms. Severity of symptoms varies greatly. Some patients’ lives have minimal impact from the disease beyond eye and mouth dryness; others develop more serious complications. Others have to learn to cope with chronic pain and fatigue.
The drying effect on eyes from SS varies and includes:
- Eye redness, itching, and burning
- Photosensitivity and glare
- Blurred vision
- Conjunctival infection
- Corneal ulceration
Dry eyes can usually treated with teardrops when only moisture is needed. But other treatment options are sometimes necessary to manage dry eye symptoms that worsen, including, methylcellulose inserts, eye ointments, medications, and even surgery.
Dryness of the mouth results from an inadequate flow of saliva. Saliva coats and lubricates tissues in the mouth. Saliva helps cleanse the mouth and begins the digestive process with chewing. Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Severe dry mouth can promote the growth of harmful organisms. Oral candidiasis, a fungal infection, has been reported to occur in up to 80% of SS patients. Without the cleansing and shielding effects of adequate salivary flow, caries [tooth decay] and periodontal [gum] disease become common problems. Constant dryness and the lack of protection provided by saliva contribute to bad breath.
Often SS patients experience changes and reduction in taste, as well as, burning sensation in the mouth. Dry mouth can cause difficulties in chewing, swallowing and speaking. Dry mouth also causes dentures to become less comfortable because there is no thin film of saliva to help them adhere properly to oral tissues.
There are numerous saliva substitutes on the market that can be prescribed, but artificial saliva is not a perfect substitute for natural saliva, which is complex physically and chemically. Most patients prefer sipping water to using a saliva substitute, since artificial saliva’s benefits are short lived. Not only is water sipping the most cost-effective means of improving oral moisture in the short-term, it has the added advantage of contributing to improved hydration. Sipping water continually during the day using a water bottle with a straw-type top is ideal.
Using saliva stimulants, such as, chewing sugar-free gum [Gum sweetened with xylitol has been shown to reduce cavities] and sucking on sugar-free candy can be helpful for increasing saliva flow. Good oral hygiene practices are particular important: brushing, flossing and using a fluoride rinse.
Venus Williams has been able to control her Sjogren’s Syndrome symptoms since she was a diagnosed in 2009. She has been amazingly able to continue to play tennis at a high level and even improve her game, which is so impressive making the Wimbledon finals. Venus Williams is a shining example and spokes person for Sjogren’s syndrome.
ENJOY LIFE AND KEEP SMILING!
George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email firstname.lastname@example.org. Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595