A 42-year-old woman presented to the Department of Dentistry with a 1-year history of loosening of multiple teeth in the mandible. Her history included difficulty in chewing food because of mobile teeth, and reduced mouth opening. She was diagnosed with systemic sclerosis 10 years ago. Intra-oral examination showed tongue rigidity and limited tongue movement. There was generalized gingival inflammation. Panoramic radiography of the jaw showed bone resorption in the right mandible and an exaggerated radiolucent area between the loosening teeth and the mandible corresponding to the location of a thickened periodontal membrane (Fig. 1A, arrows). Additionally, bone resorption of the mandibular body and angles were noted on both sides of the mandible (Fig. 1A). After one month, extractions of multiple loosening teeth were performed in the mandible. In a follow-up panoramic view taken a year later, newly developed loosening of the left maxillary molar tooth was observed (Fig. 1B, arrow). Extra-oral and oral examination showed taut, thickened, mask-like fascial skin, xerostomia, and a small oral orifice (Fig. 2).