Scleroderma may affect many structures of the head and neck, either as a localized process or as part of systemic disease.
Facial changes seen with scleroderma may include:
(1) Mona Lisa face (mask-like face)
(2) fish mouth (constricted lips)
(3) microstomia
(4) pseudoankylosis of the jaw
(5) facial hemiatrophy resembling Parry-Romberg syndrome (en coup de sabre)
(6) facial telangiectasias
Changes in the oral cavity:
(1) xerostomia
(2) dental caries
(3) chicken tongue (narrowing and stiffening of the tongue)
(4) oral ulcers and other complications of gastroesophageal reflux
(5) gingival recession and periodontitis
Changes on radiographs include:
(1) widening of periodontal ligaments
(2) resorption of bone and the mandibular angle
