Lifestyle Management Strategies
Exercise has also been shown to be anti-inflammatory, stimulating the production of anti-inflammatory cytokines and inhibiting pro-inflammatory cytokines (Petersen 2005). Psychological stress disrupts the network of signals linking the nervous, endocrine, and immune systems; also, stress reduction can significantly affect cellular immune response (Glaser 1999). A variety of exercise methods will supply symptomatic relief.
Avoiding Dry Eye
- Tear substitutes are efficient in mild to moderate cases of dry eye, although some may increase patients' complaints due to preservatives they contain. Preservatives can be avoided by using monodose disposable packaging or brands that are preservative-free (Baudouin 2004). Recent research suggests that topical cyclosporine is a promising possibility in treating dry eye (Kujawa 2004).
- Studies have demonstrated that calcium carbonate in a petroleum base relieved dry eye when applied to the lower eyelid (Tsubota 1999).
- For mild to moderate dry eye, slow-melting lubricating pellets, available by prescription and inserted into the lower pocket of the eyelid twice daily, will bring relief. Lubricating ointments are best used at night as they tend to blur vision during the day.
- Moisture-chamber eyeglasses will help preserve tear volume by minimizing airflow over the surface of the eye.
- Closing tear ducts by using collagen or silicone plugs can increase tear volume by reducing drainage. Collagen plugs are absorbed; silicone plugs are easily removed. Lower tear ducts (punta) are sealed first; a determination is then made about sealing the upper punta. If permanent closure seems warranted, electrocautery or an argon laser can permanently close the punta (Carsons 1998).
- Avoiding dust, fumes, and excessive makeup (especially around the margin of the eyelid) may also help.
Dental Caries: Protecting Your Teeth
- Brush frequently, both before and after meals, using an electric toothbrush. Floss and irrigate the teeth (using a Waterpik® or other tool) frequently. Among Sjögren's patients, oral hygiene is crucial in combating tooth decay. See a dentist regularly to monitor tooth decay and loss of enamel.
- Use a pH-balanced mouthwash to lower acidity. Try 1/4 teaspoon of baking soda dissolved in 1/4 cup of warm water. Alcohol-free goldenseal (H. canadensis) can be used as an antibacterial mouthwash. Goldenseal can help compensate for lower levels of antibacterial enzymes in the saliva. Dissolve 30 drops in 2 oz water and swish the solution in the mouth.
- Avoid sugary foods. Bacteria produce acid for 20 minutes whenever sugar is ingested. Avoid acidic foods, including citrus fruits.
- Drink non-acidic bottled water (Wu 2003).
- Use a straw to protect the mouth when drinking soft drinks and other acidic beverages.
- Avoid abrasive toothpastes that can harm already compromised tooth enamel. Certain toothpastes (eg, Biotene) have been specially formulated for individuals with dry mouth.
Fighting Oral Dryness
- Drink plenty of water to replace lost moisture in the oral cavity. Remember to avoid acidic beverages like tomato and orange juice.
- Sugarless candy or sugar-free chewing gum kept in the mouth can stimulate saliva flow. Xylitol, a sugar substitute used in candy and gum, is thought by some to inhibit dental caries. Never sleep with anything in the mouth. Many health food stores carry rice- or barley-sweetened candies.
- Avoid caffeine, which is a diuretic.
- Oral interferon-alpha in lozenge form, available by prescription, will significantly increase saliva flow (Ship 1999).
Protecting Your Nose and Throat
- Use a humidifier to keep the air moist.
- Breathe through the nose rather than the mouth; a soft cervical collar will inhibit open-mouth breathing at night by supporting the jaw. Keep your bedroom cool (Carsons 1998).
- A mixture of saline and aloe, which can relieve dry nasal membranes and nosebleeds, is gentle enough for repeated use.
Skin and Vaginal Dryness
- Avoid antibacterial and abrasive soaps; use soaps with added oils or moisturizers and moisturize the skin after bathing.