The effect of pilocarpine on dental caries in patients with primary Sjögren's syndrome: A database prospective cohort study

Chung Yuan Hsu, Kuo Chun Hung, Ming Shyan Lin, Chi Hua Ko, Yu Sheng Lin, Tien Hsing Chen, Chun Yu Lin*, Ying Chou Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

11 Scopus citations


Background: Primary Sjögren's syndrome (pSS) is associated with dental caries. Pilocarpine, a salivary stimulant, can improve the amount and flow rate of saliva in patients with pSS. This study aimed to assess whether the risk of dental caries decreases with the use of pilocarpine in patients with pSS. Methods: For this prospective cohort study, we identified pSS patients from the catastrophic illnesses registry of the National Health Insurance Research Database of Taiwan between 2009 and 2013. We divided participants into pilocarpine and non-user groups based on the pilocarpine prescriptions available during the first 3-month follow-up. The primary endpoint was dental caries. The secondary endpoints were periodontitis and oral candidiasis. We compared the risk of these oral manifestations using the Cox proportional hazard model. Results: A total of 4973 patients with new-onset pSS were eligible for analysis. After propensity score matching, we included 1014 patients in the pilocarpine group and 2028 patients in the non-user group. During the mean follow-up of 2.6 years, the number of events was 487 in the pilocarpine group (48.0%) and 1047 in the non-user group (51.6%); however, the difference was not significant (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.82 to 1.06). Furthermore, there was no significant difference between groups regarding risk of periodontitis (HR 0.91, 95% CI 0.81 to 1.03) and oral candidiasis (HR 1.16, 95% CI 0.70 to 1.94). Conclusion: Pilocarpine may have no protective effect on dental caries, periodontitis, or oral candidiasis in patients with pSS.

Original languageEnglish
Article number251
JournalArthritis Research and Therapy
Issue number1
StatePublished - 27 11 2019

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).


  • Dental caries
  • Pilocarpine
  • Primary Sjögren's syndrome


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