Microstomia (Small Mouth) and Systemic Sclerosis (SSc)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Microstomia (Small Mouth) and Scleroderma
Prevention of Microstomia
Treatments for Microstomia
Microstomia Personal Stories


Microstomia (Small Mouth) in a Scleroderma Patient, ISN Photo RepositorySystemic scleroderma can cause the mouth area to shrink and harden, which can impair chewing, brushing, flossing, and dental work. Facial exercises can help; ask your dentist or physical therapist for mouth exercises. Use child-size toothbrushes. Try to find a dentist familiar with scleroderma dental problems. (Also see What is Scleroderma?, Types of Scleroderma, and Systemic Sclerosis)

Dentists should use pediatric-size molds for impressions, provide tooth rests to ease the stress of keeping your mouth open, and arrange hand-signals for the patient to signal any discomfort during dental procedures.

For tooth extractions, see an oral surgeon so that the jaw can be relaxed manually while you are under anesthesia.

Scleroderma Lips: Deep lines around the lips worry many scleroderma sufferers but unfortunately collagen injections and laser treatment are not advisable as they may cause scarring. Tightening of the skin of the face may lead to microstomia - a small mouth. Facial and mouth exercises may help. "Disappearing lips" can be a very upsetting cosmetic problem and a reputable plastic surgeon may be able to perform an operation called a mucosal advancement. (Expired article from Royal Free Hospital web site.)

Digital Dentistry

Digital dentistry can be of value for sufferers of Microstomia. It can be used to carry out dental procedures rather than using conventional dentistry equipment. ISN.

Rehabilitation of an ocular defect with intraorbital implant and custom-made prosthesis using digital photography and gridded spectacle. Here, digital photography and a specially fabricated spectacle gridded with mm scale were used for positioning iris button on the ocular prosthesis. PubMed, J Indian Prosthodont Soc, 2019 Jul-Sep;19(3):266-271.

Use of digital impression systems with intraoral scanners for fabricating restorations and fixed dental prostheses. Restorations and fixed dental prostheses fabricated with currently available digital impression systems and intraoral scanners exhibit clinically acceptable ranges of marginal gap in both direct and indirect procedures. PubMed, J Oral Sci, 2018;60(1):1-7.


Microstomia Treatment & Management. Patients with perioral burns or fibrosis of the skin may benefit from early intervention with a preventive appliance to reduce contracture as scarring and stiffness advance. Medscape.


For UVA1 treatment, first contact your doctor to see if it they will recommend it for you. It is not used for lichen sclerosus that is on the genital area. If they recommend and prescribe it for you, try to find UVA1 facilities near you. Some dermatology offices (usually large offices or with major health centers) have UVA1 equipment (not UVB). It may also be possible to buy UVA1 phototherapy equipment for home use. It is manufactured by Daavlin and distributed worldwide. Home users must be monitored by a physician, who will prescribe the necessary dosage and monitor for possible side-effects, such as skin cancer.

Effect of Impairment-Oriented and Function-Oriented Exercises on Mouth Function in Subjects with Systemic Sclerosis. The results of this study suggest that rehabilitation appears to be useful in reducing tongue and lip impairments and in improving oral functions in subjects with scleroderma. PubMed, Folia Phoniatr Logop, 2019 Sep 24:1-13.

(Case Reports) Limited Mouth Opening Secondary to Diffuse Systemic Sclerosis. Dentists should be aware of the challenges associated with performing routine intraoral examination, periapical radiographs, and dental treatment for SSc patients with limited mouth opening. Passive jaw stretch exercises using tongue blades are modestly effective in improving the limited mouth opening in SSc patients. Hindawi, Case Reports in Dentistry.

(Case Report) A novel prosthodontic alternative for patients who are edentulous and have microstomia. This flexible denture base material can be manipulated on insertion into a smaller shape that is half the original size and is completely flexible for insertion into a mouth that has limited opening. PubMed, Spec Care Dentist.

(PDF) UVA1 Phototherapy: A concise and practical review. UVA1 phototherapy had a significant effect on collagen metabolism by reducing sclerotic plaque and lesional skin thickness, and improving skin elasticity. Skin Therapy Letter.

Improvement of microstomia in scleroderma after intense pulsed light (IPL): A case series of four patients. IPL can be a new adjunctive alternative in the non-surgical treatment of microstomia in patients with systemic sclerosis. J Cosmet Laser Ther.

A simple "fishtail flap" for surgical correction of microstomia. this relatively conservative technique, if judiciously used, can be performed with ease and safety with good results. PubMed, J Craniofac Surg.

Go to Microstomia Personal Stories

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