Multiple Sclerosis and Dental Extractions: Challenges and Solutions


Multiple sclerosis can affect many areas of your daily life, including dental care.

The symptoms of multiple sclerosis and the medications you take for these symptoms can lead to an increased need for dental visits and dental extractions.

Fortunately, there are steps you can take to help manage your dental health.

In this article, we look at how multiple sclerosis affects dental care and tooth extractions and what you can do to address these challenges.

Multiple sclerosis can affect your daily dental care and the dental care you receive from professionals.

The challenges of dental hygiene

Multiple sclerosis can make it difficult to maintain your dental hygiene. Symptoms of multiple sclerosis can cause:

  • tremors that make it difficult to hold a toothbrush and brush
  • a weakened grip that can make it difficult to hold a toothbrush
  • fatigue that can make everyday tasks overwhelming
  • facial pain and numbness that makes daily brushing and flossing painful
  • depression and other mood swings that can affect your motivation

Medication challenges

Additionally, people with multiple sclerosis are often prescribed medications that can cause dry mouth and sugary dietary supplements that can lead to plaque buildup. These medications and supplements can cause unwanted side effects, such as tooth decay and gum disease.

It can be difficult to manage these side effects while you manage the other symptoms of multiple sclerosis.

The challenges of dental care

People with multiple sclerosis may also face challenges at the dentist.

Not all dental professionals are familiar with treating people with multiple sclerosis. Often their practices are not set up for people with multiple sclerosis and may have dental chairs that are inaccessible or painful to sit in for long periods of time.

Other common dental care challenges for people with multiple sclerosis include:

  • an inability to keep the head still and in the correct position during a dental examination
  • breathing problems that make it difficult to breathe deeply while fully reclined in a dental chair
  • toothache and numbness that make it difficult to hold your mouth open without help

Regular visits to the dentist can be a challenge for people with multiple sclerosis. Visits for procedures such as tooth extractions can add to these challenges.

Tooth extractions require longer visits and can add to the pain and difficulty of standard dental work. The exact challenges and accommodations depend on the patient, the severity of their symptoms, and the number of extractions needed.

Common steps a dentist will take when a patient has multiple sclerosis include:

  • take breaks in the procedure every 5 to 10 minutes to ensure comfort
  • use a mouthpiece so that the patient does not have to hold their mouth open on their own
  • use specialized cushions or pads on the dental chair
  • coordinate with the patient’s primary care physician on medication doses on the day of the procedure

Over time, multiple sclerosis can weaken the gums. If your gums are weak and multiple sclerosis has made dental health difficult, a dentist might recommend dental implants as a solution to this problem.

Dental implants are more permanent than dentures and are often considered a better option for people with multiple sclerosis.

Consult your doctor and dentist for advice on how to perform a tooth extraction. A dentist can tailor an extraction procedure to meet your individual needs.

There are tools you can use at home to make your daily dental care easier. These include:

  • Electric toothbrushes. Electric toothbrushes can help make brushing your teeth easier and less tiring.
  • Wide or long-handled toothbrushes. Toothbrushes with wide and long handles are easier to grip and control.
  • Plastic dental floss. If regular dental floss is difficult to manage, a plastic-handled dental floss can be a big help.
  • A Waterpik. A Waterpik can help clean between your teeth and is easier to manage than dental floss.
  • A weighted glove. A weighted mitt can help keep your hand from shaking while brushing your teeth.
  • Bathroom seats. Stools and benches in your bathroom can give you a place to rest while you brush your teeth.

You can take steps to improve your dental hygiene by following a few at-home steps. These include:

  • Avoid smoking. Smoking is hard on teeth and gums.
  • Stay hydrated. Drinking water can help prevent dry mouth and help keep your mouth clean.
  • Using a humidifier. A humidifier can keep the air around you moist and help prevent dry mouth, especially at night.
  • Chewing gum. Chewing gum promotes the production of saliva in the mouth. This prevents dry mouth and it can help prevent cavities. Sugar-free gum is recommended.
  • Make regular dental appointments. Seeing the dentist regularly is an important part of staying healthy.
  • Have a well-balanced diet. Limit foods high in sugars and acids.
  • Replacing your toothbrush every 3 months. Bacteria and plaque can build up on your toothbrush. Additionally, worn bristles can be too abrasive on your gums, which can lead to gum recession and inflammation.

Can multiple sclerosis affect the nerves in the teeth?

Multiple sclerosis can cause a type of nerve pain called trigeminal neuralgia. Trigeminal neuralgia is not in your teeth. Instead, it’s nerve pain on the side of your face.

However, this pain is often felt in the teeth and in the jaw. This can make dental work or even toothbrushing very painful.

Can a tooth extraction with multiple sclerosis lead to a stroke?

No, there is no link between multiple sclerosis, dental extractions and strokes.

Are there certain dental treatments to avoid with multiple sclerosis?

Usually no. But multiple sclerosis can vary from person to person. Even people with the same type of multiple sclerosis can have very different symptoms and progressions.

As is the case, some people may have specific symptoms or take medications that could potentially interfere with certain dental treatments. Talk to your doctor and dentist before having any treatments to make sure they are safe.

Is the risk of post-extraction infection higher due to a weakened immune system from multiple sclerosis?

Although multiple sclerosis is an immune system-related condition, it does not directly weaken your immune system.

It causes your body’s immune system to attack healthy nerve cells, but does not prevent your immune system from fighting infections. This means that you are not at an increased risk of post-extraction infections.

However, many people with multiple sclerosis take medications, such as corticosteroids, which can weaken the immune system. That’s why it’s important to tell your dentist about all the medications you’re taking before having an extraction or any other dental procedure.

You may need to take antibiotics to help prevent infection after your extraction.

If you develop a tooth infection, it can lead to a pseudo-exacerbation, which is a temporary increase in multiple sclerosis symptoms.

Dental health can be a challenge for people with multiple sclerosis. Symptoms and medications can increase the risk of tooth decay and gum disease. This can make visiting the dentist a stimulating and challenging experience.

People with multiple sclerosis who need tooth extractions may struggle with lengthy dental procedures. It is best to consult your doctor and dentist on the best way to perform an extraction. Some dentists and dental practices may be better prepared to help people with multiple sclerosis.

Taking steps to protect dental health is one of the best ways to avoid tooth extractions. Using resources such as the proper dental hygiene equipment and taking the time to develop good oral health habits can help people with multiple sclerosis manage their dental health.


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