Multiple Sclerosis Dental Implants
It may be challenging for patients with Multiple Sclerosis (MS) to find a dentist who is able to accommodate their dental visits. However, MS patients should ensure they are comfortable, their visit is as enjoyable as possible, and that their needs at met at the dentist.
With more than 900,000 adults who are currently living with Multiple Sclerosis (MS), it can be easy to ignore the negative effects that the condition can have on a patient’s oral health. In addition, it can be quite challenging to find a dentist who is able to effectively manage the various dental issues associated with MS. Because of their unique needs, it is extremely important for patients with MS to have a positive, comfortable, and painless experience at their dental appointments. Do not hesitate to schedule a consultation or place a phone call to ensure the dental office is able to properly treat patients with MS and adequately meet their needs.
Multiple Sclerosis (MS) is a degenerative, progressive neuromuscular disorder which typically results in partial or full paralysis. There is not currently a known cure. MS is a complication which occurs in the nervous system. The disorder attacks a patient’s brain and spinal cord. It severely impairs the myelin sheath, which is the material which protects the nerve cells. Because of this, messages which are traveling to and from the brain or body begin to slow down or are completely blocked. Partial and complete remissions are both common with MS. This disorder causes the demyelination of the nerves of the central nervous system. Demyelination is the removal of the fat-like protective sheath which surrounds and protects the nerves. This process can cause the following symptoms:
- Complete failure of the transmission for nerve impulses
- Decrease in the speed of nerve conduction
- Modified methods of the transmission of nerve impulses
- Partial blockage of the nerve conduction
As a result of not recognizing the impact that MS can have on a patient’s oral health care, individuals with MS are especially susceptible to suffering from unnecessary pain and treatments. Many preventative dental procedures can significantly improve the oral health and lives of patients who are living with the disorder.
Multiple Sclerosis and Dental Care
MS is associated with various dental health complications and issues. A prevalent issue is the weakening and eventual loss of the patient’s ability to control their muscles. As a result of the disorder, it is often challenging for MS patients to perform routine dental hygiene habits which include brushing and flossing. As with any patient, poor oral hygiene allows for the growth of bacteria, decay, gum problems and other issues.
Individuals who have severe cases of MS, often need to schedule shorter dental appointments to ensure they remain comfortable. Based on the severity of the patient’s MS, the dental office should make special considerations and adjustments. Individuals who have severe MS typically require shorter dental appointments, and it may be best to schedule their appointments early in the morning. In the event a longer appointment is necessary, the dentist should schedule short breaks every 30 minutes, or as needed. Patients with MS should also be seated at a 45-degree angle. This helps to avoid compromising their airway. It is common for MS patients to develop respiratory issues from the impact on the muscles which control breathing. A rubber dam may be helpful to use during the appointment, only if the patient is able to properly breathe through their nose. In addition, it can be difficult for MS patients to keep their mouth open for extended periods of time. As a result, a mouth prop may be beneficial to aid the patient in comfortable keeping their mouth open throughout the appointment.
It may also be difficult for patients with MS to specifically identify the source of their pain or discomfort. It is important for the dentist to be patient and extremely thorough in the diagnosis of dental problems prior to pursuing significant treatment options such as a root canal or tooth extraction. In some cases, individuals with MS may develop trigeminal neuralgia, which causes chronic pain affecting the trigeminal nerve, the nerve which carries sensation from the face to the brain. Patients also report experiencing temporary numbness of the teeth, jaws, and lips. Multiple Sclerosis can cause partial or complete paralysis of the face. This creates additional challenges with any dental procedures.
Additional considerations for MS patients can include requiring wheelchair access in cases where the disease has progressed, and possible anesthesia or sedation.
Oral Care and MS
For patients with MS, thorough dental hygiene and care become increasingly difficult to maintain at home. Due to this, patients are often at a greater risk for cavities, periodontal diseases, and developing infection. Some of the other common symptoms of MS patients include difficulty in swallowing food, using the tongue and with adequate production of saliva.
Because of the loss of muscle control, simple tasks such as brushing and flossing are increasingly challenging for the patient. Brushing and flossing aids can be purchased at the pharmacy or provided by the dentist. Caregivers are also encouraged to assist with at home oral care, when needed.
Various medications which are commonly used for MS patients, such as immune-suppressant drugs, corticosteroids, muscle relaxants, and antidepressants, often cause a dry mouth. This can lead to cavities and gum disease. It is important for the patient to ensure their mouth remains hydrated. Salivary substitutes and fluoride treatments are often used.
Patients with severe forms of MS may find it challenging to use dentures. Because MS are more prone to a dry mouth, it can be increasingly difficult to eat, talk, and wear an oral appliance. Muscle spasticity makes it both difficult and even dangerous to wear these types of removable appliances. MS patients should talk to their dentist regarding the potential of using dental implants to anchor and support the denture. This helps to reduce the chances of the dentures dislodging or becoming loose. Dental implants are an excellent solution which can provide strong support for dentures and eliminate many of the challenges MS patients often experience.
MS and Facial Pain
Depending on which nerves are being attacked, MS can cause many different types of symptoms. A common symptom includes facial pain, which often presents itself as trigeminal neuralgia and TMJ (temporomandibular joint). Trigeminal neuralgia is nerve pain which occurs between the face and the brain. While these is no proven connection between the two things, studies has demonstrated that MS can play a role in TMJ disorders.