How Will Multiple Sclerosis Affect Your Dental Treatment?
June 29th, 2011
Muscles
Multiple sclerosis could partially or totally paralyze patients face making it difficult for the dentist or hygienist to work intraorally. MS patients have reported temporary numbness in patient’s teeth, checks, jaw or lips. So you might need to be aware that these signs and symptoms indicate multiple sclerosis not only to identify the early detection of the disease but knowing that the patient has oral symptoms will help you identify the proper treatment planning and proper human needs of the patient. Some MS patients can experience difficulties swallowing, decreased amount of saliva or difficulties of proper use of the tongue. In these conditions its harder for the patient to maintain a good oral hygiene therefore the patients will be at high risk for tooth decay and periodontal disease.
Brushing and flossing
The primary concern that arises in multiple sclerosis patients is the loss of muscle control. This condition can limit the ability to brush and floss using appropriately oral self care tools. In cases where the patient can at least manage to brush easy certain areas of teeth but have difficulties brushing for example posterior teeth, modified brushes or stick floss helpers might be considered ( this depends on the actual muscles that are effected). Every little effort from patients side should be encouraged no matter how little they are. Sometimes patients with severe MS symptoms can require other people assistance to manage oral hygiene care. In this case the caregiver should be motivated to work with the patient, see possible ways that can help the patient become independent and discuss them with the dental hygienist or dentist to find the best possible methods that will help patient maintain a good oral hygiene independently or with less possible help from the caregiver. It is important to emphasize that the most common problems that dental professionals might have to deal with when treating MS patients with severe MS symptoms are: halitosis periodontal disease ( typical problems that are usually associated with poor oral hygiene).
Helping devices during the treatment
It could be hard for the patient to open his mouth for extended periods of time. Controlling patients tongue movements and swallowing could also be a problem. You may use a rubber bite block or a mouth prop in to keep patients mouth open during treatment to avoid any possible tissue trauma. Your can also use a tongue retractor to keep patients tongue steady. A thin piece of rubber or a rubber dam could be so that the patient won’t inhale foreign substances while being treated.
Sedatives
If we use sedative methods like LA , the client may have worse control of the muscles. Make sure you reveal the proper information regarding the medication that the patient is taking so it wont interfere with the sedative injection. You might want to consider patients physician for more information.
Dentures
With time multiple sclerosis might get worse and effect that category of MS patients that wear different types of dental prosthetic aids like full or partial dentures. Muscle spasticity makes it almost impossible the wearing of dentures and the more severe these episodes are the more likely is the patient to hurt him self or even worse swallow them. In fact people that are known to suffer from MS shouldn’t be prescribed or recommended for removable dentures. There are many other possible solutions to avoid all these problems by installing mandibulary or maxillary implants that can support the denture and decrease the accidental risks of dislodging the denture while MS symptoms occur.
Appointment time
You should keep the length of your dental visits at a comfortable length of time because you must avoid as much stress and fatigue as possible for the patient. In general MS clients have a hard time sitting in the dental chair during lengthy appointment and its advised that the dental professional needs to allow multiple brakes of 5 to 10 minutes every half our treatment. When we deal with paralyzed patients that are not able to move upper or lower limbs the situation becomes more complicated. Try to change their position during the appointment to minimize stress. The treatment will require more time due to possible lack of dexterity that affects clients oral hygiene directly and possible muscle soreness since the client is immobile during the appointment time. To reduce patients discomfort its recommended to set up the dental chair with pads. In this way pads will avoid pressure sores and will make the patient feel more comfortable during the appointment. Remember that for these category of patients its best to schedule the appointments early in the morning because it is less stressful for the patient. Also use extra caution in accommodating the patient in the dental. Use specific procedures designed to transfer patients that are on wheel chair. If heavy require the help of a second clinician. You might want to discuss these issues with the patient.
1. Possible ways that will help the patient maintain a normal oral function
2. Possible ways that will make patient increase oral hygiene care (OSC) and be independent in performing them.
3. How to improve self appearance that will maintain a high level of self-esteem and will make him feel “included” in the society
Tags: Care Tools, Dental Professionals, High Risk, Ms Patients, Ms Symptoms, Multiple Sclerosis, Muscle Control, Oral Hygiene Care


