Systemic Sclerosis Oral Features — MFDS Part 1 MCQ

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ModerateHuman DiseaseSystemic Sclerosis Oral FeaturesMFDS Part 1

A 52-year-old woman reports progressive difficulty inserting a toothbrush and tolerating dental treatment because her mouth opening has reduced. Examination shows tight, fibrotic perioral skin with microstomia and reduced tongue mobility associated with a fibrotic lingual frenum. Which underlying autoimmune condition is most likely?

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Correct answer: E — Systemic sclerosis

Systemic sclerosis is the correct answer. It is an autoimmune connective-tissue disease characterised by fibrosis and microvascular dysfunction. Fibrosis and tightening of the perioral tissues produce progressive microstomia, which can impair oral hygiene, eating and access for dental treatment; frenum fibrosis may also restrict tongue movement. Rheumatoid arthritis can restrict opening through temporomandibular joint disease but does not characteristically cause fibrotic perioral skin. Sjögren syndrome principally causes salivary and lacrimal hypofunction. Systemic lupus erythematosus is more associated with oral ulceration, while dermatomyositis causes inflammatory muscle weakness and characteristic cutaneous eruptions rather than progressive perioral fibrosis.

Reference: Almurait S, Alqahtani H, Ratnapalan S, Johnson SR. Oral and maxillofacial manifestations of systemic sclerosis. Best Practice & Research Clinical Rheumatology. 2026;40(2):102119. https://pubmed.ncbi.nlm.nih.gov/41692633/