Oral health is an important part of healthy daily living, although research suggests people living with a chronic disease may neglect their general health and wellness, including oral health. Healthy teeth and gums are essential for preventing infections that may cause MS symptoms to worsen, promoting good digestion and proper nutrition, improving the enjoyment of food and social activities, and maintaining appearance. Most dental problems can be prevented through daily oral healthcare routines.
Elements of good care
Your dental care should include:
Brushing twice daily with fluoride toothpaste: after breakfast and before bedtime
Flossing daily and using a tongue scraper or brushing the tongue daily
Eating a well-balanced diet without excessive sweets
Scheduling regular dental visits, usually every 6 months
Replacing your toothbrush at least every 3 to 4 months
Reporting any bleeding gums, tooth or jaw pain, or tooth sensitivity
Routine dental visits
The dental hygienist or dentist will inspect your teeth, gums, tongue, and throat at regularly scheduled checkups. A typical dental examination will involve an oral cancer screening (examining your face, neck, lymph nodes, soft tissues, and jaw joints), looking for loose or broken teeth, or damaged fillings, and checking for gum disease. You may also have an X-ray of your teeth to look for signs of decay or damage.
In addition to cleaning, polishing, and flossing your teeth, the hygienist or dentist might also go over brushing and flossing techniques.
Certain procedures may require local anaesthetic (freezing), and some people choose sedation dentistry to help them feel more relaxed during their visit. There are no restrictions on the type of anesthesia that can be used for a person with MS during dental procedures, you and your dentist can choose whichever type of anesthesia is most comfortable for you.
Dental Problems That may be Found During a Dental Examination:
Tooth decay (cavities) | Holes in the tooth enamel |
Periodontal disease | Inflamed and infected gums |
Bruxism | Grind teeth or clench jaw usually during the night |
Malocclusion | Upper and lower jaw do not close properly |
Most oral health conditions are preventable and can be treated early, so it’s important to be aware of certain health and lifestyle risk factors that can contribute to dental problems. Medication use, stress, and sleep apnea are common in people living with MS. It’s important to talk to your dental hygienist or dentist about any oral health concerns that may be related to these risk factors.
Health Risk Factors |
Age Diabetes Medications Stress and anxiety Sleep apnea |
Lifestyle Risk Factors |
Alcohol A diet that is high in sugar Not taking action to prevent disease Smoking, using smokeless tobacco, and vaping Smoking/ingesting cannabis Oral piercings/jewelry |
(Source: Canadian Dental Association)
Dental Care and MS Symptoms
There are MS symptoms that can interfere with the proper care of the teeth and gums. Fatigue, spasticity, weakness, tremor, facial pain (trigeminal neuralgia), and sensory changes (numbness, tingling, and/or pain) in the hands can all challenge a person’s efforts to brush and floss. These strategies and tools can help make up for these problems:
Toothbrush with built-up handles (or cut a small slit in the sides of a tennis ball and slide it onto the handle of the toothbrush); electric toothbrushes and flossing devices.
Sitting down to brush and floss if standing is tiring.
Flossing at bedtime is better since it removes bacteria that will multiply while you sleep, but if you’re too tired at night to floss, make it part of your morning routine.
Ask a family member or personal assistant to help with tooth brushing and flossing.
Manage tremors by wearing a weighted glove while brushing.
Some medications used to treat MS symptoms can cause dry mouth. Saliva helps to cleanse the mouth and teeth. A dry mouth is not only uncomfortable, but it may cause bacteria to grow and can also interfere with chewing. Also, spicy or salty foods may cause pain in a dry mouth. Here are some ways to help with dry mouth:
Sipping water or sugar-free drinks often.
Avoiding caffeine, tobacco products, and alcohol.
Using a small squirt of lemon in the mouth or sugarless lemon candies to stimulate the glands in your mouth that control saliva.
Using a humidifier at night.
Using special products that are available in pharmacies to moisten dry mouth.
Managing Dental Visits and MS Symptoms
Some MS symptoms can affect scheduling a dentist visit. Plan to manage symptoms like fatigue, poor balance, spasticity, and/or transportation issues by finding out in advance if the dental office is accessible, including any specific accommodations you might need during your visit. If possible, schedule your dental appointments for a time of day when you feel the most rested.
MERCURY AMALGAM and MS
There have been claims over the years that mercury leaking from amalgam dental fillings damages the immune system and causes a broad range of diseases, including MS. While the cause of MS remains unknown, there is no scientific evidence that heavy metal poisoning is responsible for either the onset or worsening of MS. There is no reason to have your dental fillings removed or replaced. This is a very expensive procedure with no proven benefit for people with MS.
Resources
Canadian Dental Association
A national body dedicated to the promotion of optimal oral health.
Directory of Dental Regulatory Authorities & Provincial/Territorial Associations
Contact information for all the dental regulatory authorities and associations across Canada.
This resource has been adapted by MS Canada with the permission of the National Multiple Sclerosis Society (USA). www.nationalMSsociety.org
09/2024