Multiple Sclerosis Dental Implants
Multiple Sclerosis is a complication in the nervous system that attacks the spinal cord and brain. When a person has multiple sclerosis, referred to as MS, their immune system attacks the myelin sheath that protects the nerve fibers in the spinal cord, resulting in improper communication between the brain and the body and most often will lead to physical disability and permanent damage to the nervous system. Multiple sclerosis often leads to partial or full paralysis.
Symptoms vary and depend largely on the amount of nerve damage present and the specific nerves that may be affected. Common symptoms usually include the lack of control or coordination of the muscles, loss of balance or memory loss, and localized feelings of numbness and weakness. Some people will face significant disability while others can experience long asymptomatic periods. There is no cure currently for multiple sclerosis, but treatments can help people with MS manage symptoms and affect the severity of the disease.
Dental Problems for Patients with MS
Multiple Sclerosis (MS) is an overwhelming disorder with many dental health complications. One is the weakening and eventual loss of muscle control. This medical disorder makes it difficult for someone suffering from it to perform common dental hygiene habits like brushing and flossing. Poor dental hygiene will result in bacteria attacking and compromising the teeth’s defenses.
Multiple Sclerosis patients often find it hard to stay relaxed at a dental appointment, which then leads to prolonged examinations and dental procedures. The challenge for the dentist is now to keep the appointment as short as possible, as this can cause fatigue, stress, and muscle spasms to arise.
A primary symptom of multiple sclerosis is inflammation, which is a defense effort prompted by the immune system. Gum disease is also inflammatory, and the inflammation caused by the gum disease can then trigger systemic inflammation, prompting MS flare-ups. These MS flare-ups increase inflammation in the gum tissue, in a cycle that deteriorates the immune system and destroys the gum tissue. Preventative dental care can be particularly important for patients with multiple sclerosis. Dental hygiene and home oral care pose significant challenges. MS patients can also face difficulty in swallowing, using the tongue, and producing saliva, all of which can adversely affect the health of the mouth, teeth, and gums.
Many of the medications prescribed to treat MS can also lead to a condition known as xerostomia, which is an excessive dryness in the oral cavity, and which stimulates the growth of cavities and gum disease. Deliberate hydration can help prevent the problems caused by xerostomia, as can salivary substitutes and fluoride treatments. Some medications can also cause oral ulcers, which makes brushing and flossing even more painful. Dentists may also recommend brushing and flossing aids, which are available over the counter, or they can recommend helping with home care. People with multiple sclerosis can find it helpful to brush their teeth while sitting down, as the muscles fatigue more easily. They may also prefer to floss while sitting down.
The Effects of Multiple Sclerosis on the Dental Implant Procedure
Frequent dental care is especially important for patients with multiple sclerosis, who should plan to visit their dentist at least twice a year, if not more often. When a patient with multiple sclerosis need to see the dentist, there are multiple factors to consider. Depending on the severity of the MS disease, patients might require shorter dental appointments, preferably in the morning hours when well-rested, to minimize muscle spasms and other uncomfortable symptoms.
When longer appointments are unavoidable, frequent breaks are necessary; general guidance suggests short 5-to-10-minute breaks every thirty minutes. Patients with multiple sclerosis need to sit at a 45-degree angle, keeping their airways open, as many MS patients develop respiratory problems with their breathing muscles. If the patient can breathe through their nose, a rubber dam might be recommended. It might also be painful or even stressful for the patient to voluntarily keep their mouth open for an extended period, and a mouth prop can be used to help hold the mouth open.
Many patients with multiple sclerosis find it difficult pinpointing the specific source of their discomfort or pain, which makes accurate diagnosis even more challenging. Dentists need to take great care and use all available resources before recommending more invasive procedures like dental implants. Patients with multiple sclerosis may also develop a pain in the face, known as trigeminal neuralgia, or temporary numbness in the face, jaw, and teeth. Multiple sclerosis can lead to partial or even total paralysis of the face, which will greatly complicate many dental procedures. Patients with more advanced multiple sclerosis might also use wheelchairs, which raises concerns if wheelchair access is not immediately available.
Dental Implants Versus Dentures for Multiple Sclerosis Patients
When tooth decay and gum disease do develop in patients with multiple sclerosis, causing the teeth to either fall out or to be extracted, many different types of dental restorations will come with their own set of challenges. Removable dentures, either partial or full, can be problematic for patients with multiple sclerosis. Xerostomia may make it difficult to wear removable dentures and usually affects the ability to eat or to talk, and symptoms of MS can also make it difficult to both remove and properly insert the dentures. Muscle spasticity can make removable dentures quite difficult to wear, and in more severe cases of MS, removable dentures can be dangerous. If the patient faces swallowing difficulties due to the multiple sclerosis, a bulky removable denture can exacerbate these difficulties and lead to choking or the inability to eat. For dental patients with multiple sclerosis, dental implants can be immensely helpful, as they can support the denture and minimize the chances of slipping or dislodging, and they will not interfere with the patient’s ability to talk or to swallow. In many cases, patients with multiple sclerosis can receive the placement of dental implants with no complications.
Certain medications can interfere with the healing of the gums and bone, so be sure to tell your dentist your complete and entire medical history if you are discussing the possibility of dental restoration treatment with dental implants.