Multiple Sclerosis Dental Implants
Multiple Sclerosis (MS) is a progressive and degenerative neuromuscular disorder. It often results in partial or complete paralysis. There is currently no known cure for the disorder. MS is a complication which exists in the nervous system. The disorder attacks the patient’s spinal cord and brain, severely impairing the myelin sheath. This is the material which protects the nerve cells. As a result, messages which are intended to travel to and from the brain or body can slow down or be blocked completely. Both partial and complete remissions are common in MS. The disorder causes the demyelination of the central nervous system nerves. Demyelination is the removal of the fat-like protective sheath that surrounds the nerves and works to protect them. The following are common symptoms:
- Nerve conduction experiences a partial blockage
- Nerve impulses create modified methods of transmission
- The speed of nerve conduction decreases
- The transmission for nerve impulses completely fail
When there is a failure to recognize the impact MS can have on the patient’s oral health, individuals who have MS are particularly prone to unnecessary treatments and pain during appointments. There are many preventative dental procedures which can dramatically improve the oral health of patients living with the disorder.
In some cases, it is difficult for Multiple Sclerosis (MS) patients to find a dentist who is willing to work with them and make special accommodations for their visits. It is important for MS patients to be comfortable, have an enjoyable visit, and ensure their unique needs are met.
Over 900,000 adults currently live with Multiple Sclerosis (MS). It is sometimes easy to overlook how the condition impacts the oral health of a patient. It can also be time consuming and challenging to identify a dentist who can effectively manage the variety of dental issues which are often associated with MS. Due to the unique needs of an MS patient, it is critical that they have a positive, comfortable, and pain-free experience at when visiting the dentist. MS patients should not hesitate scheduling a consultation or calling the office to ensure they are able to properly treat MS patients and meet their unique needs.
Multiple Sclerosis and Dental Care
MS is often associated with a variety of dental health issues and complications. One issue which is especially prevalent is the weakening and eventual loss of the ability for the patient to control their muscles. Because of the degenerative disorder, MS patients often find it challenging to perform routine dental hygiene habits such as brushing and flossing. When patients have poor oral hygiene practices, there can be increased risk for the growth of bacteria, decay, gum problems and other issues.
Patients with severe cases of MS, often find it helpful to schedule shorter dental appointments. This helps to ensure they remain comfortable throughout their visit. Depending on how severe the patient’s MS is, the dental office may need to make special adjustments and accommodations. Individuals with severe MS may also benefit from scheduling their appointments early in the morning. When longer appointments are required, the dentist should be prepared to take short breaks about every 30 minutes. It is also helpful for MS patients to be seated at a 45-degree angle as this avoids compromising their airway. MS patients often develop respiratory issues as a result of the impact on the muscles used to control breathing. The dentist may opt to use a rubber dam during the appointment. This should only be done if the patient is able to effectively breathe through their nose. It can also be challenging for MS patients to keep their mouth open for a long period of time. A mouth prop may be helpful in keeping the patient comfortable throughout their visit.
It can be especially challenging for MS patients to identify the specific source of their discomfort. The dentist needs to be patient and extremely thorough when diagnosing oral issues before involved treatment options such as a root canal or tooth extraction are pursued. Some MS patients develop trigeminal neuralgia, which results in chronic pain that affects the trigeminal nerve. This is the nerve that carries sensation from the face to the brain. The patients also often report temporary numbness of their teeth, jaws, and lips. It is possible for Multiple Sclerosis to cause partial or complete face paralysis. Paralysis creates significant challenges as it relates to any dental procedure.
Some of the additional considerations that may apply to MS patients include the need for wheelchair access, anesthesia or sedation.
Oral Care and MS
Effective dental hygiene and care can become increasingly challenging for MS patients maintain on their own at home. MS patients have a greater risk for developing cavities, periodontal diseases, and infection. Some of the other common challenges and symptoms that impact MS patients include issues with swallowing, use of the tongue and in adequate saliva production.
Due to the loss of muscle control, simple tasks which may include brushing and flossing, become more challenging. Brushing and flossing aids are available and can be provided by the dentist or purchased at the pharmacy. It may also be necessary for the patient’s caregiver to assist with at home oral care needs.
It is common for some of the medications frequently used for MS patients, such as immune-suppressant drugs, corticosteroids, muscle relaxants, and antidepressants, to cause a dry mouth. A dry mouth and lack of saliva production can result in gum disease and cavities. Patient should ensure their mouth stays hydrated to maintain good oral health. It is common for the dentist to recommend the use of salivary substitutes and fluoride treatments.
Once MS has significantly progressed, the patient may find it more difficult to comfortably use dentures. MS patients are more susceptible to having a dry mouth, it makes it very challenging to eat, talk, and wear oral appliances. In addition, muscle spasticity can make it dangerous and difficult to wear removable appliances. In some cases, MS patients may benefit from the use of dental implants for anchoring and supporting their dentures. This aids in reducing the risk of the dentures becoming loose or breaking.
MS can cause a wide range of symptoms based on the nerves which are being attacked. One common symptom is facial pain, which may present itself as trigeminal neuralgia and TMJ (temporomandibular joint). Trigeminal neuralgia is nerve pain occurring between the brain and the face. While there is not a proven connection between the two things, data has shown that MS may play a role in a TMJ disorder for the patient.