Dental Implants for Patients with Multiple Sclerosis
For patients with Multiple Sclerosis (MS) finding dental providers with teams that can make dental visits as accommodating as possible may be a challenge. Approximately 1 million American adults are currently living with MS. For this population, it is not always easy to find a dentist that can address the various oral health issues that individuals living with MS may face. If you or someone you love is living with MS, you may be seeking information on what dental treatments are possible for you or your loved one. Below is more information on tooth replacement treatments, such as dental implant treatment, for patients with MS.
What is Multiple Sclerosis (MS)?
MS is a progressive neuromuscular condition. Over time the immune system attacks the protective material, called the myelin sheath, that surrounds the nerve cells in the central nervous system. When this tissue is damaged it results in disruption of the communication between the brain and muscles in the body. Blocking the communication between the brain and body leads to a decrease in the speed or blocking of nerve conduction, change in the transmission of nerve impulses, or a complete breakdown of nerve impulse transmission. Symptoms of MS include impaired muscle control, coordination, balance, and memory, and uncomfortable feelings of prickling and numbness. Unfortunately, MS gets progressively worse overtime and can result in partial or full paralysis. For some patients, symptom remission can happen and is common. Given all of this, individuals with MS are particularly susceptible to suffering from unnecessary pain and treatments. Due to the many pressing health conditions faced by patients with MS, oral health care may not always be a priority. This lack of attention can result in decay, tooth loss, and added pain. Patients with MS who maintain their preventative dental care can significantly improve their oral health and their lives.
Dental Problems for Patients with Multiple Sclerosis
Patients with MS also face many dental health complications. The loss of muscle control can make performing routine dental hygiene such as daily brushing and flossing challenging. If daily dental hygiene is not maintained at home, bacteria will build up, attack gum tissue, and compromise oral health. Thus, patients with MS are often at increased risk of developing cavities, gum disease, and infections as their MS advances. Additionally, dental visits can be a challenge as sitting through an appointment without pain and discomfort is unlikely. Inexperienced dentists may take longer to perform examinations and dental procedures. Experienced dentists can keep dental appointments brief, treat the oral health of the patient, and minimize the occurrence for MS symptoms such as fatigue, stress, and muscle spasms.
Fortunately, there are ways to help patients with MS to maintain daily hygiene at home and help maintain good oral health, including:
- Modified brushing and flossing aids are available at pharmacies or through dental providers.
- Caregivers are encouraged to and can help with daily hygiene when appropriate.
- For patients with MS, keeping the mouth hydrated can help battle the dry mouth that is caused by medications often prescribed to patients with MS (such as immune-suppressant drugs, corticosteroids, muscle relaxants, and antidepressants). Dry mouth can stimulate cavity growth and the development of gum disease.
- Adding extra fluoride treatments to dental visits can restore enamel on the teeth.
How is Dental Care Impacted by Multiple Sclerosis?
For patients with MS, keeping dental appointments brief and comfortable is essential to effective dental care. Special considerations may need to be made by the dentist depending on the severity of the patient’s MS, for example:
- Offering breaks: If longer appointments are necessary for specific dental treatments, dentists should consider offering the patient 5-10 minute breaks as often as necessary. If the patient with MS is concerned about getting the treatment because they will have to sit for prolonged periods, they should request breaks prior to the start of the treatment.
- Discuss respiratory problems: Some patients with MS also struggle with respiratory problems, therefore it is also important to make sure the patient is seated in a position to help aid their breathing and open their airway. Additionally, the dentist should have a discussion with the patient to make sure a rubber dam will not cause additional breathing difficulty.
- Mouth positioning: Due to muscle control challenges, keeping the mouth in an open position for extended periods of time may also be difficult for patients with MS. If this is a potential concern, there are mouth props available to help the mouth remain open comfortably.
- Oral pain: If patients with MS have been experiencing oral pain, dentists should perform a thorough exam prior to committing to treatment procedures. For example, some patients with MS experience temporary numbness in the teeth, jaws, and lips that cannot be treated through dental procedures.
- Additionally, sometimes patients with MS experience partial or total paralysis of the face, making dental care more challenging.
- ADA access: Additionally, dental providers should ensure there is appropriate ADA access to their dental clinic.
Dentures and Dental Implants
Maintaining daily oral hygiene is important for all adults, including patients with MS. If oral health has declined and tooth loss occurs, tooth replacement treatments may also be particularly challenging. But, this does not mean that tooth replacement treatments are not possible. While dentures are an affordable and easy tooth replacement option, for patients with MS they may not be the best choice. As muscle impairment symptoms advance, maintaining denture fit will pose a challenge.
Dental implants may offer a perfect tooth replacement treatment option for patients with MS. Dental implants are metal posts that are surgically installed into the jawbone. Once healed, this implant acts like the root of a natural tooth, and an artificial crown, dentures or a bridge can be securely attached on top. Implants provide a solution to the issues created by dentures, offering a stable and secure tooth replacement option. While the implant treatment process can take 6 months to 1 year, each of the procedures and follow-up appointments should be relatively quick and easy.