Multiple Sclerosis
Multiple sclerosis (MS) is a disease which affects the brain and central nervous system. There is unfortunately no cure for the disease. Patients who have MS commonly have symptoms associated with their immune system attacking the myelin sheath. The myelin sheath works to protect the spinal cord nerve fibers. There can be a challenge in the communication between the body and the brain. This can slowly result in physical disabilities and permanent nerve damage over time. In most cases of multiple sclerosis, the patient will eventually experience partial or full paralysis.
As with many diseases, the symptoms associated with MS can significantly vary from patient to patient. The symptoms depend on what nerves are affected and the severity of nerve damage which takes place. Some of the common symptoms may include a loss of muscle coordination or control, balance or memory challenges, numbness, and weakness. The side effects can range from debilitating to extended periods of being asymptomatic. While there is not a cure for the disease, effective treatments can aid in managing the symptoms.
Inflammation
A primary characteristic associated with multiple sclerosis is inflammation. Inflammation is actually a defense mechanism that the immune system triggers. Other inflammatory diseases are gingivitis and periodontitis. When patients have inflammation caused by gum disease, it can also trigger an MS flare-up. When patients have a flare-up, there is a release of biochemicals which may increase gum inflammation. Over time, this cycle can cause damage to the gum tissue and immune system. For patients with multiple sclerosis, it is critical to practice good oral hygiene and be diligent in preventative dental care. It is common for MS to struggle with practicing good oral hygiene at home. Common symptoms of the disease include the loss of muscle control and muscle weakness, making it difficult to brush and floss the teeth. Patients who have poor oral hygiene can quickly experience tooth decay and other oral health problems. In advanced cases of MS, the patient may struggle with daily tasks such as swallowing, tongue use, and saliva production. Common medications used for the treatment of MS symptoms often cause xerostomia or excessive mouth dryness. This can cause issues such as cavities and gum disease.
Dry Mouth
Patients should work diligently to hydrate in order to prevent issues from a chronically dry mouth. Dentists or medical professionals may also suggest that patients use a prescription saliva substitute and fluoride treatment which can help protect the teeth. Certain medications can cause oral thrush or ulcers in the mouth which may cause serious discomfort when brushing or flossing. Patients may be encouraged to use an aid for brushing or flossing. Dental professionals may also suggest that the patient’s caregivers give assistance with oral hygiene. Some MS patients find it helpful to sit or lay down when brushing or flossing their teeth.
Dental Visits
Regular visits to the dentist are important in maintaining good oral hygiene, this is especially vital for patients with multiple sclerosis. MS patients should work with their dentist to determine the frequency of routine visits which should occur twice or more each year. Depending on the severity of the disease, the patient may require certain modifications which could include morning appointments or shorter appointments. When longer appointments are needed, the patient may need to take periodic breaks or break the appointment into separate visits when possible. It is recommended that providers give MS patients a short break about every thirty minutes. It may also be helpful for multiple sclerosis patients to sit at a 45-degree angle to keep their airways open. Another common side effect of MS is for patients to develop respiratory issues from the impact the disease has on the muscles used for breathing. In some cases, patients find it beneficial to use a rubber dam during the appointment. It may be uncomfortable and stressful for patients to keep their mouths open for extended periods during an appointment. A mouth prop can be used in this case to help comfortably keep the patient’s mouth open. Dentists must work diligently to ensure patients remain comfortable throughout their appointment.
Oral Pain
In some cases, it can be difficult for patients with multiple sclerosis to determine their source of pain. This can make it challenging to provide an accurate diagnosis for oral pain and issues. Dentists must be diligent and ensure they are providing patients with an accurate diagnosis. Invasive procedures like a root canal or tooth extraction should only be performed if it is absolutely necessary and there are no other solutions. Extreme pain and temporary numbness of the face is another common side effect of multiple sclerosis. The disease can cause partial or complete facial paralysis, causing serious complications with most types of dental procedures. In an advanced case of multiple sclerosis, the patient will likely require the use of a wheelchair which may make it challenging for the patient to access the dental office.
Gum Disease and Decay
It is not uncommon for patients with MS to experience tooth decay and gum disease. These dental issues can result in serious oral health issues and even result in tooth loss. There are unique challenges related to dental restorations for MS patients. It can be challenging for multiple sclerosis patients to wear traditional dentures. Dentures may make it challenging for the patient to perform routine tasks such as eating and speaking. The symptoms and limitations associated with MS can also make it difficult to place and remove dentures. If the patient has difficulty in swallowing due to their multiple sclerosis, this can be made worse with dentures.
Dental Implants
Patients with multiple sclerosis can find it incredibly helpful to use dental implants for the replacement of missing teeth. The implants can also be used to support dentures. Implants offer a strong and secure foundation while avoiding the risk of the prosthetic teeth slipping or falling out. Dental implants have an incredibly high success rate with a low risk for complications, regardless of whether the patient has MS. Some medications make it more challenging for the body to heal. Patients with multiple sclerosis who are considering dental implants must be diligent in sharing their medical history and medications with the dentist prior to the procedure. The dentist can help determine if the patient is a good candidate for implants.
Multiple sclerosis is a serious disease, and patients must take their oral health seriously. MS patients can be at risk for oral health problems such as tooth loss. Patients must work diligently to practice good oral hygiene and maintain good oral health. MS patients who are missing one or more teeth should work with their dentist to determine if they are a good candidate for dental implants to restore the function and appearance of their missing teeth.
Contact the office today to schedule an appointment with one of the dentists. The dental team is eager to work with all patients, including those who have multiple sclerosis.