Primary biliary cirrhosis. Sole presentation with rampant dental caries.

A 55-year-old woman was referred by her general dental practitioner for management of rampant dental caries of recent onset. Examination revealed a very dry mouth, angular stomatitis, and multiple carious lesions. Labial salivary gland biopsy showed features consistent with Sjögren's syndrome. Hematologic investigations showed antimitochondrial antibodies at a titer of 1 in 320, highly suggestive of primary biliary cirrhosis that was confirmed by liver biopsy.