Multiple sclerosis, or MS, is a lifelong disease that affects your brain, spinal cord, and the optic nerves in your eyes. It causes problems with muscle control, balance, and vision, along with other every day body functions. Motor function and coordination are heavily affected, with muscle weakness and spasticity making everyday tasks like holding a toothbrush near impossible. Problems with coordination and fatigue also make it difficult to keep up with proper dental care. All of these complications result in MS patients being at a higher risk for dental diseases. The disease itself affects the teeth and gums on a biochemical level, along with the medications used for treatment.

There is a cause and effect relationship between MS and dental health. One of the main characteristics and symptoms of MS is heightened levels of inflammation. This happens as a result of the immune system deteriorating. Gingivitis and periodontal (gum) disease are more likely to occur because of this. When inflammation occurs due to the nature of Gingivitis, a flare of MS symptoms manifest. These MS symptoms in turn release chemicals that penetrate the gum membrane and cause more inflammation. It is a never ending cycle, that without dental intervention, will deteriorate a patient’s health. Dental procedures can be used to treat gum disease and it’s symptoms but without proper prevention, a patient’s oral health will continue to deteriorate.

Oral medications used to treat MS also contribute significantly to the onset and symptoms of oral disease. Many MS medications aim to even out and control the immune system. These medications end up causing dry mouth (xerostomia), swollen gums (gingival hyperplasia), oral ulcers (ulcerative stomatitis), oral thrush (candidiasis), and reactivation of the herpes viruses. Lack of saliva caused by dry mouth causes a multitude of dental problems. Saliva is needed to reduce plaque, stop the growth of bacteria, and wash away food debris. Without this, tooth decay and gum disease can develop. The other side effects of MS medication, like oral ulcers and swollen gums, make it painful or even impossible to brush and floss properly.

Dental care is incredibly important for MS patients. Having good oral hygiene can reduce symptoms. It is important to schedule regular dental visits. At the least, biannual checkups are a must for MS patients. Depending on how well patients practice oral hygiene at home, dental appointments may be needed more frequently. There a few dental tips that can help reduce negative oral symptoms. When dealing with fatigue, patients should sit down while brushing their teeth. They can also floss while in bed. If a patient has trouble holding their toothbrush, wrap foam around the handle to get a better grip. They can also try wearing weighted gloves to steady their hand movements. Electric toothbrushes are a great alternative to consider. For dry mouth, use formulated mouthwash or chew sugarless gum to stimulate saliva.