May 7, 2026

Sjögren’s disease is notoriously difficult to diagnose: The main symptoms — persistent dryness of the eyes and/or mouth — can have many different causes and develop gradually, making it hard to pin down their source. Additionally, there is no single test to diagnose Sjögren’s disease; multiple tests are needed. The diagnosis is a bit like solving a puzzle: Different pieces are brought together to form the complete picture.

Rheumatologist Alan Baer, director of the Jerome L. Greene Sjogren’s Disease Center, explains how Sjögren’s disease is diagnosed and what to expect.

How is Sjögren’s disease diagnosed?

There isn’t one test that can tell if you have Sjögren’s disease. Your doctor must carefully review all of your symptoms to rule out any other potential causes. He or she may send you to see specialists to look for key elements of the disease:

• An insufficient tear film on your eyes
• Decreased saliva production
• Salivary gland inflammation
• An underlying autoimmune disorder (a disorder in which your body’s immune system mistakenly attacks itself)

Diagnosing Sjögren’s disease requires gathering a lot of information, which your doctors will collect from a combination of tests on your eyes and mouth, blood and urine, and biopsies. These will be in addition to taking a medical history and performing a physical exam, the results of which may determine other tests your doctors will perform.

What should I do if I think I have Sjögren’s?

Since Sjogren’s is difficult to diagnose, and the symptoms require different medical specialists, you may need to visit several doctors.

• Primary care doctor: Start with a visit to your primary care doctor, who can help triage your symptoms to the right specialists and connect the dots among seemingly unrelated concerns.
• Ophthalmologist: Dry eye is one of the most common symptoms. An ophthalmologist can help investigate what is causing your dry eyes.
• Dentist: Dry mouth is another common symptom, so you may need to see a dentist or oral health specialist to investigate.
• Rheumatologist: Your primary care provider may refer you to a rheumatologist, a type of doctor who specializes in autoimmune conditions like Sjögren’s disease. Rheumatologists are often the “go-to” specialists for diagnosing and managing Sjögren’s disease, especially in its more severe forms.

Specific Tests for Sjögren’s Disease

To make a Sjögren’s disease diagnosis, doctors look for two things:

1. Salivary and/or tear gland dysfunction.
2. That the dysfunction is caused by your body’s own immune system (autoimmune).

To establish that pattern, they may recommend some or all of the following tests:

• Blood and urine tests to look for the presence of antibodies common in Sjögren’s disease. The results of ANA (antinuclear antibody) and anti-SSA antibody tests will help determine if you have an autoimmune disorder.
• Schirmer’s test to see if your tear glands are producing enough tears to keep your eyes moist.
• Ocular surface staining to look closely at the surface of your eyes for damage and dryness.
• Salivary gland function scans, which assess the ability of the major salivary glands below your ears, under your tongue and under your jaw to produce saliva.
• A biopsy of your lip to look for inflammation of the minor salivary glands. This test can determine the type of inflammation and its severity. A biopsy of the lip is performed because minor salivary glands just under the lip’s inner surface are the easiest glands to access, and they can reflect changes that are occurring in the major salivary glands.
• Sialometry, which measures the flow of saliva.
• Ultrasonography of the major salivary glands to reveal characteristic structural changes that can aid in diagnosis.

How long does it take to get a Sjogren’s diagnosis?

On average, it takes three years from the time symptoms are noticed to reach a Sjögren’s disease diagnosis.

Why is a Sjögren’s disease diagnosis so important?

For patients, the lengthy process to diagnose Sjögren’s disease can be frustrating, but the process is worth the wait. Getting an accurate diagnosis is important for several reasons:

• Sjögren’s disease can affect multiple parts of the body, sometimes without any symptoms. An accurate Sjögren’s disease diagnosis ensures your care team is on the lookout for specific long-term complications.
• Since dryness symptoms can have many causes, it is important to determine that Sjogren’s is the cause, particularly if drugs that suppress the immune system are being considered for treatment.
• Treatment options vary greatly, depending on the extent and severity of your Sjögren’s disease. An accurate diagnosis will allow your doctor to better customize your care and offer the treatments most likely to alleviate your symptoms.

Medically reviewed by Alan Baer, M.D.