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As with other autoimmune disorders, the symptoms of Sjogren's syndrome develop slowly over time. Due to the slow progression of symptoms, there is typically up to a 10-year gap between the onset of symptoms and diagnosis of the disorder. Also, because of the typical age range of onset of Sjogren's syndrome (middle-age women), some symptoms of Sjogren's syndrome can be confused with symptoms often seen with normal aging (e.g., vaginal dryness) which can delay the accurate diagnosis of Sjogren's syndrome.

Diagnosis of Sjogren's syndrome is often difficult to establish with people who present with less definitive symptoms or borderline antibody values. In addition, sicca symptoms, namely dry eyes and dry mouth, can be present with so many other medical conditions which adds to the difficulty in identifying primary Sjogren's syndrome.

Early and accurate diagnosis of Sjogren's syndrome is important because initiation of appropriate therapy can prevent further damage. For example:

• Treating the symptoms of dry mouth can reduce oral problems such as cavities, periodontal diseases, oral infections
• Treating the symptoms of dry eyes can minimize ocular damage
• Earlier diagnosis and initiation of treatment for systemic complications of Sjogren's syndrome can improve prognosis (chance of recovery)

There is no single diagnostic test available for Sjogren's syndrome. Rather, a combination of factors including signs/symptoms, a careful medical history, physical examination, and select diagnostic and laboratory tests are used to establish the diagnosis. In many cases, patients will be referred to several medical specialists (e.g., rheumatologist, ophthalmologist, and dentist) who, by working together, are able to link the pieces of the puzzle to arrive at an accurate diagnosis.