Lupus and Vitamin D

Vitamin D is a Marker for Disease

Vitamin D deficiency is a marker for disease activity and damage in systemic lupus erythematosus.  Low levels of vitamin D are associated with autoimmune diseases, especially lupus.  It is activated by a chemical reaction made possible by exposure to the sun's ultraviolet B rays.  Since people with lupus may need to avoid sun exposure because of the photosensitivity side effects of medications, this can increase the risk for vitamin D insufficiency, as can kidney failure and treatment with steroids.  209 people were studied at the Ohio State University Medical Center in 2008.  The patients were mostly women, with an average age of 40, having had lupus for an average of eight years and having a variety of clinical features, most prevalent being kidney and skin involvement.  Results in these patients indicated that the more vitamin D in the blood, the lower the lupus disease activity, and vice versa.  The authors recommended that all people with lupus continue to use sunscreen and consult with their physicians about adequate intake of vitamin D. 

Source:  LFA  Research Report  

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Lupus Treatment: Oral and Dental Complications

Syndrome of Lupus

All Lupus patients suffer from some sort of oral involvement, and these complications often come about as a side effect of medical treatment. Certain forms of organ involvement carry dental warnings: with kidney involvement, certain antibiotics (tetracycline) or analgesics (aspirin, NSAIDS) adversely affect kidney function. Antibiotics need to be given prior to treatment for those with Liebman-Sacks Endocarditis (a form of heart involvement) or mitral valve prolapse. Nitrous Oxide (laughing gas) is contraindicated for those with lung problems. Caution should be taken with patients with abnormal bleeding. Those with Sjogren's Syndrome usually have severe dry mouth that may result in massive decay, dental infections, yeast infections and gum disease.

Oral Health 

Medications: Anti-convulsants can cause gum atrophy and bleeding. Anti-malarials (plaquenil) can cause intraoral rashes. Immunosuppressive agents (methotrexate) suppress the immune system and may result in bacterial or fungal infections. NSAIDS (advil, motrin, feldene, daypro) can cause oral ulcers. Steroids--prednisone and other corticosteroids increase the likelihood of bacterial and oral fungal infections. Any medications which cause dry mouth put the patient at risk for tooth decay and gum disease.

Lupus patients require frequent dental checkups and periodontal maintenance to optimize their oral health.

Source:  Lupus Guide to Dental Care, HeatherGalusha-Phillips

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309