Existing cavities must also be treated, as cavities that extend into the tooth cannot be effectively treated by teeth cleaning alone, and are at a high risk of spreading into the pulp of the tooth, leading to the loss of vitality and need for extraction or root canal therapy. This treatment regimen is the same as for all xerostomia patients, such as for those undergoing head and neck radiation therapy, which often damages the salivary glands; these glands are more susceptible to radiation than are other body tissues. Prognosis
Published studies on the survival of Sjögrens syndrome patients are limited in varied respects, perhaps owing to the relatively small sample sizes, and the fact that secondary Sjögrens syndrome is associated with other autoimmune diseases. Results from a number of studies indicate that, compared to other autoimmune diseases, Sjögrens syndrome is associated with a notably high incidence of malignant non-Hodgkin lymphoma, a cancer of white blood cells. About 5% of patients with SS develop some form of lymphoid malignancy. Patients with severe cases are much more likely to develop lymphomas than patients with mild or moderate cases. The most common lymphomas are salivary extranodal marginal zone B cell lymphomas (MALT lymphomas in the salivary glands) and diffuse large B-cell lymphoma.Lymphomagenesis in primary Sjögrens syndrome patients is considered as a multistep process, with the first step being chronic stimulation of autoimmune B cells, especially B cells that produce rheumatoid factor  at sites targeted by the disease.
In situ studies did not show increased apoptosis among glandular epithelial cells, but did show reduced apoptosis among infiltrating mononuclear cells. Reduced apoptosis was also implicated in the accumulation of autoreactive B-cells found in the glands. The relationship of autoantibodies expressed in Sjögrens syndrome with apoptosis is still being researched. Hormonal factors
Sex hormones seem to influence humoral and cell-mediated immune response, with estrogen being considered one of the biggest factors responsible for sex-immunologic dimorphism. Estrogen deficiency appears to play a role in development of Sjögrens syndrome. It has been hypothesized that androgen administration to the ocular surface may serve as an effective therapy for dry eyes. Diagnosis
Diagnosing Sjögrens syndrome (SS) is complicated by the range of symptoms that a patient may manifest, and the similarity between symptoms of Sjögrens syndrome and those of other conditions. Also, patients with SS symptoms approach different specialities for treatment, which can make diagnosis difficult. Since dry eyes and dry mouth are very common symptoms, and frequently occur in people over 40, affected people may believe that the symptoms are age-related, so ignore them. Some medications can cause symptoms similar to those of Sjögrens syndrome. The combination of several tests, which can be done in a series, can eventually diagnose Sjögrens syndrome.Blood tests can be done to determine if a patient has high levels of antibodies that are indicative of the condition, such as antinuclear antibody (ANA) and rheumatoid factor (because Sjögrens syndrome frequently occurs secondary to rheumatoid arthritis), which are associated with autoimmune diseases.