Contemporary Treatment of Oral Manifestations of Sjögren’s Syndrome: A Narrative Review

Abstract

Background: Oral manifestations of Sjögren’s syndrome, particularly xerostomia caused by salivary gland hypofunction, impair oral function, increase the risk of dental and mucosal complications, and reduce quality of life. Symptomatic management remains the mainstay of treatment, although several emerging therapies have recently been investigated. Aim: To review current evidence on established and emerging treatments for the oral manifestations of Sjögren’s syndrome. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Publications from January 2015 to July 2026 were analyzed to evaluate conventional management, pharmacological and physical therapies, prevention of oral complications, and systemic immunomodulatory approaches. Results: Conventional management, including patient education, saliva substitutes, topical fluoride, dietary modification, and preventive dental care, remains the cornerstone of treatment. Pilocarpine and cevimeline are the most effective secretagogues in patients with preserved salivary gland function but are limited by cholinergic adverse effects. Sialendoscopy and intraductal irrigation show the strongest evidence among minimally invasive therapies. Current evidence does not support hydroxychloroquine, conventional immunosuppressants, rituximab, or abatacept for isolated oral dryness. Emerging targeted therapies, including ianalumab, dazodalibep, and nipocalimab, have shown promising preliminary results. Conclusions: Management should be individualized and multidisciplinary, combining symptomatic relief, preservation of residual salivary gland function, prevention of oral complications, and appropriate treatment of systemic disease. Targeted therapies are promising but require confirmation in larger clinical trials..