Is there a link between MS and oral health problems?

Question

Hello doctor,

My mother, who is 55, has multiple sclerosis and is struggling with serious dental and oral health complications. She has noticed that her mouth constantly feels dry, and she is developing frequent mouth ulcers that take a long time to heal. As a retired teacher who loves socializing, these symptoms make her feel self-conscious and uncomfortable.

She also experiences burning sensations in her tongue and sometimes has difficulty swallowing. Her dentist seems unsure about the cause of these symptoms.

Are these oral health issues directly connected to multiple sclerosis?
What strategies can she use to manage these challenges?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns.

Yes, the oral health issues your mother is experiencing, such as dry mouth, frequent mouth ulcers, burning sensations in her tongue, and difficulty swallowing, are indeed related to her multiple sclerosis (MS). These symptoms are likely connected to the disease and its effects on the nervous system. Here is how MS can impact oral health and strategies for managing these challenges:

Dry mouth (xerostomia) happens when the nerves that stimulate the salivary glands don’t work as efficiently. Saliva plays an important role in protecting the teeth and gums, so when it is reduced, the mouth can feel constantly dry and sore, and the risk of cavities, gum problems, and infections goes up.

The burning or tingling sensation in the tongue and mouth is also something we see in MS and is usually linked to nerve irritation rather than a dental infection alone. Swallowing difficulties can occur when MS affects the muscles and coordination needed to move food and liquids safely, which can make eating stressful and tiring for her.

Strategies for managing oral health complications include

Regular dental checkups are crucial for people with MS, particularly for those experiencing dry mouth and other related issues. A dentist familiar with MS can provide tailored advice and treatments. Brushing twice a day with fluoride toothpaste and flossing daily are essential. A soft-bristled toothbrush is recommended to prevent injury to sensitive gums. Fluoride treatments prescribed by a dentist can help protect teeth against decay due to reduced saliva production. Additionally, an alcohol-free mouthwash can help reduce bacteria and promote the healing of ulcers without causing dryness.
Over-the-counter oral lubricants can help alleviate dry mouth symptoms. These are often available as sprays, gels, or mouth rinses and help keep the mouth moist. Encouraging your mother to drink water throughout the day can help alleviate dry mouth. Sugary drinks should be avoided as they can exacerbate oral health issues. Chewing gum or sucking on sugar-free candies can stimulate saliva production.
If mouth ulcers are frequent and painful, a dentist may recommend topical treatments, such as gels or pastes containing corticosteroids or other anti-inflammatory agents, to reduce pain and aid healing. Certain foods and drinks can exacerbate burning sensations, such as acidic, spicy, or very hot foods. Identifying and avoiding these triggers can help manage symptoms. Sometimes, vitamin deficiencies can also contribute to these symptoms. Ensuring adequate intake of vitamin B12 through diet or supplements might help alleviate the burning sensation.
Soft foods, smoothies, and purees can make swallowing easier. Using thickening agents with liquids can also help prevent choking. A speech therapist experienced in dysphagia can provide exercises to strengthen swallowing muscles and techniques to make swallowing safer and more comfortable.

It is a good idea to keep both her neurologist and dentist informed about these symptoms so they can work together and adjust her care if needed. Small changes in diet, hydration, and daily routines can go a long way in improving her comfort and helping her continue to enjoy meals and social time with family.

I hope this helps you.

Thank you.