By David Hudnall, DMD
Multiple sclerosis is an autoimmune condition that affects the nerves of the brain, spinal cord, and the optic nerve. Destruction to myelin, the protective layer that surrounds nerve fibers, interferes with their ability to send electrical signals, resulting in a range of unpredictable symptoms, including numbness, tingling, pain, memory problems, vision problems, difficulty walking, and generalized weakness.
According to the National Multiple Sclerosis Society, about 85% of people diagnosed with MS have relapsing-remitting MS characterized by flare-ups of the active disease followed by periods of partial or complete remission. While the disease affects the body as a whole, what are some of the things that must be considered when it comes to multiple sclerosis dental implants or dental health in general?
Dental Complications and Multiple Sclerosis
Dental disease prevention is key when it comes to preserving dental health for everyone, but especially for those dealing with a systemic disease. People living with multiple sclerosis have an increased propensity for suffering from dental diseases, largely because they often neglect their health and well-being when the symptoms of MS make it difficult to practice good oral hygiene or properly care for their teeth. Fatigue, weakness, lack of coordination, and generalized pain of the central nervous system make it quite challenging to engage in preventative dental care like brushing and flossing effectively every day. Because of this, patients are often faced with dental disease that has gotten out of hand, necessitating dental extractions and dentures to eliminate the source of mouth infections and tooth pain.
Known side effects of medications used to treat MS symptoms also contribute to the development of oral diseases that lead to conditions such as dry mouth, oral ulcers, and thrush (an overgrowth of fungus). Without adequate saliva production, swallowing can be difficult, sugars are not neutralized, dental plaque is allowed to form, bacteria take over, and there is nothing to help wash away food debris, leading to a total breakdown of dental and oral health issues everywhere.
Denture Options for Patients with MS
While it is possible for MS patients to have traditional dentures, the lack of adequate saliva sometimes makes it difficult to comfortably wear them. Patients who also experience difficulty swallowing may have particular issues that can lead to choking. The side effects associated with dry mouth, coupled with dexterity and motor skill problems or partial or full paralysis that make dentures hard to remove and insert, often cause wearing dentures to be a challenge for multiple sclerosis sufferers.
Basics of the Dental Implant Procedure
The dental implant placement procedure has become very straightforward and somewhat routine, thanks to CBCT scanning, surgical stents, and prior treatment planning that allows the implant surgeon to precisely insert implants into the jawbone in specific locations to gain the greatest denture stability. Most implant surgeries are performed in the dental clinic under local anesthesia. If multiple implants are being placed, as in the case of the all-on-4 system, all of the implants are inserted within a single appointment that typically lasts between one and two hours.
Then, the waiting begins. Implant dentistry depends upon the body’s immune response to heal as the implants integrate and become one with missing teeth and the surrounding bone. This process can be more uncertain with patients who have systemic health issues, as is the case with multiple sclerosis and dental implant acceptance. With less-than-perfect health, there is a greater possibility for implants to fail. Proper home care and frequent follow-up visits with your surgeon can go a long way toward improving implant success. It usually takes between four and six months to achieve full implant integration before the restorative phase of treatment can begin.
See Also: The Best Dental Implant Types and Techniques
Frequently Asked Questions
What does it all mean when it comes to multiple sclerosis and dental implants? Are multiple sclerosis patients candidates for dental implants? Let’s address some of the common concerns.
Can You Have Dental Implants If You Have MS?
Because dental implants keep dentures stable, they prevent the denture from causing issues with choking or swallowing. This is one of the benefits that multiple sclerosis patients can expect from dental implants. Since dentures do not have to rely on suction for their stability, implant dentures on the upper arch can be constructed so that the palate and back of the throat are not covered, making it easier to swallow.
In many cases, patients with multiple sclerosis can receive dental implants with no complications. However, there are certain medications that may interfere with healing and integration after implant surgery. That is why it is critical for patients to inform their dentist about their complete medical history and all of the medicines that they currently take or have taken in the past when discussing the possibility of dental restoration treatment with dental implants.
How Does Multiple Sclerosis Affect Dental Treatment?
Many MS patients have difficulty undergoing long dental procedures. Scheduling short dental appointments will help patients whose symptoms include muscle spasms, stress, or fatigue be more comfortable during and after treatment. When longer appointments are necessary, your dentist should allow for short breaks at least every half-hour. Try to schedule appointments at a time of day that best aligns with your peak energy level.
Because multiple sclerosis has symptoms that include numbness, muscle control, or partial paresthesia, pinpointing the origin of mouth discomfort or pain often proves to be difficult. This is why a thorough and careful diagnosis is essential before committing to undergoing invasive procedures like dental extractions or dental implant placement.
Who Is Not a Good Candidate for Dental Implants, In General?
Generally, you must be in good physical health to undergo bone grafting procedures and implant surgery. Any type of disease, medication, or condition that alters the body’s healing response or restricts normal blood flow will affect implant integration and the outcome of dental implant treatment. These include:
- Lack of sufficient bone quantity and bone density, including periodontal disease. In some cases, this can be corrected with bone grafting surgery prior to implant placement.
- Uncontrolled systemic diseases such as diabetes, high blood pressure, autoimmune diseases.
- Patients taking steroids or blood thinners. The risks associated with these medications can sometimes be managed by adjusting the dosage or avoiding the medications for a period of time prior to and after surgery.
- History of cancer treatment using bis-phosphonate drugs.
- Prior radiation treatment to the jaws.
- Smoking. Smokers may be candidates if they abstain before and after implant surgery.
Can Dental Work Cause an MS flare?
Receiving dental care in and of itself does not cause a flare-up of multiple sclerosis symptoms; rather, inflammation is the reason for a dentally-related flare-up. Inflammation in multiple sclerosis patients occurs as the immune system attacks itself. One of the main characteristics of MS is a heightened or overly active inflammatory response, a byproduct of the immune system’s own defense mechanism. Chronic inflammation is an unhealthy state for anyone to live in. For patients with an already compromised immune system, there can be unintended negative consequences.
Gingivitis and periodontal (gum) disease are more likely to progress when patients aren’t able to perform their daily dental and oral hygiene practices and routines. Additional inflammation occurs due to gum disease, causing a flare-up of MS symptoms. The MS symptoms, in turn, release additional chemicals that penetrate the gum tissue, causing greater inflammation and more pain. Left untreated, it can lead to a perpetual cycle of higher levels of inflammation. In certain cases where the natural teeth are no longer salvageable, it may make sense to remove any remaining teeth, thereby eliminating the source of dental inflammation. Your dentist will discuss this possibility should it become a reality.
Effective Dental Care for MS Patients
Multiple sclerosis can be a lifelong debilitating disease. If you suffer from it, doesn’t it make sense to do whatever possible to ease symptoms and live more comfortably? Dental care is no exception. If you are faced with the reality of losing your teeth and getting dentures or already have dentures that you can no longer wear, European Denture Center has solutions. And we’ll see if dental implants might be an option for you. At European Denture Center, your better health is our primary concern. Know all of your options. Consult with us today!