Dental Health THE BASIC FACTS

MULTIPLE SCLEROSIS

Kim, diagnosed in 1986

People with a chronic disease may neglect n Enhancing the enjoyment of food and social their general health and wellness, research activities shows. Dental care is no exception. A tendency n Maintaining appearance to focus on MS-related needs may divert people’s attention from appropriate dental care. People with significant fatigue and/or Elements of good care mobility impairment may find office visits beyond those required for their MS care to Diligent routine care can help prevent dental be particularly difficult to manage. problems. Your dental care routine should involve: The basic fact is healthy teeth and gums are n essential for: Brushing twice daily: after breakfast and before bedtime n Preventing infections which may cause MS n Using a tooth-paste with fluoride in it symptoms to increase n Flossing daily n Promoting good digestion and proper n nutrition Using a tongue scraper or brushing the tongue daily

Dental Health | 1 n Eating a well-balanced diet without excessive sweets Common dental n Scheduling regular dental visits, usually every 6 months problems that may n Replacing your toothbrush at least every 3 to be identified 4 months n Promptly reporting any bleeding gums, tooth During the examination the dentist will or jaw pain or tooth sensitivity look for: n Caries or tooth decay—also known as “cavities” because holes develop in the tooth enamel Routine dental visits n Periodontal disease, which causes inflamed and infected gums During the regularly-scheduled checkups, the n Bruxism, which occurs when a person clenches dentist inspects your teeth, gums, tongue, and his or her jaws or “grinds” teeth, usually during throat. A typical dental examination involves: the night n An oral cancer screening which includes n Malocclusion, when the upper and lower jaw examining your face, neck, lymph nodes, soft do not close properly tissues, and jaw joints (“TMJ”s) Caries and periodontitis are infections, each n Looking for loose or broken teeth, or of which can be made worse by bruxism and damaged fillings malocclusion. n Checking for gum disease n X-raying your teeth for signs of decay or damage n Inspecting your bite Dental care and n Checking any dental appliances you might have (bridge, night guard, bite plate) MS symptoms n Cleaning (to remove plaque and tartar), There are several symptoms of MS that can polishing, and flossing your teeth interfere with adequate care of the teeth and n Reviewing brushing and flossing techniques gums. Fatigue, spasticity, weakness, tremor, n Scheduling any needed dental treatment facial pain (trigeminal neuralgia) and sensory (Note: There are no restrictions on the type changes (numbness, tingling, and/or pain) of anesthesia that can be used for a person in the hands can all challenge a person’s efforts with MS during dental procedures; you and to brush and floss adequately. The following your dentist can choose whichever type of strategies and assistive devices can compensate anesthesia is most comfortable for you.) for these problems:

Dental Health | 2 n Use toothbrushes with built-up handles (or n Finding out ahead of time whether the office cut a small slit in the sides of a tennis ball and building is sufficiently accessible slide it onto the handle of the toothbrush); use n Making your special needs known to the flossing tools; consider electric toothbrushes office staff before your appointment and flossing devices. n Determining whether the office has a dental n Sit to brush and floss, if standing at the basin chair that is sufficiently accessible for you is tiring. (keep in mind that persons who use wheelchairs n Floss in the morning if you are too tired at may need other types of assistance as well) night. Since flossing at bedtime is preferable n Getting some extra rest beforehand to because it removes bacteria that will multiply compensate for the traveling and the office visit while you sleep, try flossing in bed. n Scheduling visits for a time of day when you n Allow a family member or personal assistant usually feel the most rested to help with tooth brushing/ flossing. n Planning to rest upon returning from the n Manage tremors by wearing a weighted glove dental visit while brushing. Some medications used to treat MS symptoms can cause dry mouth. Saliva helps to cleanse THE TRUTH ABOUT the mouth and teeth. A dry mouth is not only MERCURY AMALGAM uncomfortable, it may cause bacteria to accumulate and may also interfere with There have been claims over the years that chewing. In addition, spicy or salty foods may mercury leaking from amalgam dental fillings damages the immune system and causes a cause pain in a dry mouth. You can minimize broad range of diseases, including MS. While the effects of dry mouth by: the cause of MS remains unknown, there n Sipping water or sugarless drinks often is no scientific evidence that heavy metal n Avoiding caffeine, tobacco, and alcohol poisoning is responsible for either the onset or worsening of MS. There is no reason to n Using a small squirt of lemon in the mouth have your dental fillings removed or replaced. or sugarless lemon candies to stimulate the This is a very expensive procedure with no parotid glands (which control saliva) proven benefit for people with MS. n Using a humidifier at night n Using special products that are available in pharmacies to moisten dry mouth Resources Dental visits and MS symptoms Academy of General Dentistry 211 East Chicago Avenue Suite 900 Plan to handle the challenges of fatigue, poor Chicago, Illinois 60611 balance, spasticity, and/or transportation Tel: 888-243-3368 issues by: Web site: www.agd.org/patient-resources.aspx

Dental Health | 3 > Oral health resources WheelchairNet Find a dentist > The RERC (Rehabilitation Engineering

> Ask a question Research Center) on Wheeled Mobility 5051 Forbes Tower American Dental Association University of Pittsburgh 211 East Chicago Avenue Tel: 412-383-6586 Chicago, Illinois 60611 Web site: www.wheelchairnet.org/WCN_ Tel: 312-440-2500 Living/Docs/accessibledentistry.html Web site: www.mouthhealthy.org/en > Accessible dentistry for persons who use > Current consumer topics wheelchairs

> A to Z resources > Consumer tips

> Finding a dentist > Resources advocating accessible dental care  > Events and news > Architectural accessibility for dental practices Association of State and > Some accessible dental practices Territorial Dental Directors > Education and training resources Bibliography and journals Web site: www.astdd.org > > Names of dental department heads for By Aviva L. Andreen, DDS, Attending Dentist, Special every state Care Treatment Center, New Jersey Dental School, University of Medicine and Dentistry of New Jersey > Contact information for every state dental department of health * The National Multiple Sclerosis Society is proud to be a source of information about multiple National Foundation of sclerosis. Our comments are based on professional Dentistry for the Handicapped advice, published experience and expert opinion, but do not represent individual therapeutic 1800 15th Street Suite 100 recommendation or prescription. For specific Denver, Colorado 80202 information and advice, consult your personal physician. Tel: 303-534-5360

Web site: http://dentallifeline.org nationalMSsociety.org > Donated Dental Care in 50 States (for the For Information: 1 800 FIGHT MS medically compromised, disabled or elderly (1 800 344 4867) person who has no means of paying and who needs comprehensive dental work) © 2014 National Multiple Sclerosis Society EG 0742 > Dental house calls/van (volunteer dentists make home visits to disabled persons)

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