MS Effects on Physical and Oral Health

Author: Kimberly N. Powell, DDS, MS, FAGD

Multiple Sclerosis (MS) is a chronic autoimmune disease.  It can occur at any age, even as early as 20 years old.  Symptoms include blurred vision, difficulty walking, tingling or numbness, fatigue, poor coordination, paralysis, slurred speech, and poor cognition.  Resulting complications can include further muscle weakness.  Some of the oral complaints associated with MS have been difficulty swallowing, TMJ pain, dry and burning mouth, and tooth sensitivity.  The goal of treatment for MS is to slow development and progression of the disease.  Unfortunately, some medications used to treat MS can lower the body’s resistance against systemic and oral infections (i.e., thrush).  Other oral adverse reactions are dry mouth, oral ulcers, bleeding gums, inflammation of the tongue, and oral swellings.  The disease itself and the medication to treat it put MS individuals at risk for poor oral health.  Fatigue, muscle weakness, compromised coordination caused by the disease can make toothbrushing and flossing difficult.  To compensate for these challenges, more frequent dental visits could be scheduled with a preference towards morning appointments were fatigue is less likely to be present.  During dental appointments, adjusting the chair where it is less reclined can prevent breathing difficulties.  At home modifications could consist of using manual toothbrushes with bulky handles and/or power brushes, using a weighted glove when brushing to help control hand tremors, and to sit during oral hygiene care.  There is an increased risk for dental caries and erosion from dry mouth.  For caries control, applying an in-office fluoride varnish, using a prescription-level fluoride toothpaste at home and salivary substitutes are beneficial.  Treating patients affected by MS poses its challenges.  However, the challenges that the clinical team face pales in comparison to the individual living with the disease.  Hence, our goal is to provide the best information and service for our patients who come to us for care.

 Source for article content:  Multiple Sclerosis and Oral Health, Fiona Collins, BDS, MBA, MA, FPFA, colgateoralhealthnetwork.com