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Dental health.

People with a chronic disease may neglect their general health and wellness, research shows. Dental care is no exception. A tendency to focus on MS-related needs may divert people's attention from appropriate dental care. Individuals with significant fatigue and/or mobility impairment may find office visits beyond those required for their MS care to be particularly difficult to manage.

The basic fact is that healthy teeth and gums are essential for preventing infections that may cause MS symptoms to increase, promoting good digestion and proper nutrition, enhancing the enjoyment of food and social activities, and maintaining appearance.

Elements of Good Care

Diligent routine care can help prevent dental problems. Your dental care routine should involve:

(1) Brushing twice daily: after breakfast and before bedtime

(2) Using a toothpaste with fluoride in it

(3) Flossing daily

(4) Using a tongue scraper or brushing the tongue daily

(5) Eating a well-balanced diet without excessive sweets

(6) Scheduling regular dental visits, usually every six months

(7)Replacing your toothbrush at least every 3-4 months Promptly reporting any bleeding gums, tooth or jaw pain, or tooth sensitivity

Routine Dental Visits

During regularly scheduled checkups, the dentist inspects your teeth, gums, tongue, and throat. A typical dental examination involves an oral-cancer screening that includes examining your face, neck, lymph nodes, soft tissues, and jaw joints (TMJs); looking for loose or broken teeth or damaged fillings; checking for gum disease; x-raying your teeth for signs of decay or damage; inspecting your bite; checking any dental appliances (bridge, night guard, bite plate); cleaning (to remove plaque and tartar), polishing, and flossing your teeth; reviewing brushing and flossing techniques; and scheduling any needed dental treatment. [Note: There are no restrictions on the type of anesthesia that can be used for a person with MS during dental procedures; you and your dentist can choose whichever type of anesthesia is most comfortable for you.]

Common Dental Problems

During the examination the dentist will look for caries or tooth decay--also known as "cavities" because holes develop in the tooth enamel; periodontal disease, which causes inflamed and infected gums; bruxism, which occurs when a person clenches his or her jaws or "grinds" teeth, usually during the night; and malocclusion, when the upper and lower jaws do not close properly.

Caries and periodontitis are infections, each of which can be made worse by bruxism and malocclusion.

Dental Care and MS Symptoms

Several MS symptoms can interfere with adequate care of the teeth and gums. Fatigue, spasticity, weakness, tremor, facial pain (trigeminal neuralgia), and sensory changes (numbness, tingling, and/or pain) in the hands can challenge a person's efforts to brush and floss adequately. The following strategies and assistive devices can compensate for these problems:

* Use toothbrushes with built-up handles (or cut a small slit in the sides of a tennis ball and slide it onto the handle of the toothbrush); use flossing tools; consider electric toothbrushes and flossing devices.

* Sit to brush and floss, if standing at the basin is tiring.

* Floss in the morning if you are too tired at night. Since flossing at bedtime is preferable because it removes bacteria that will multiply while you sleep, try flossing in bed.

* Allow a family member or personal assistant to help with tooth brushing/flossing.

* Manage tremors by wearing a weighted glove while brushing.

Some medications used to treat MS symptoms can cause dry mouth. Saliva helps cleanse the mouth and teeth. A dry mouth is not only uncomfortable, but it also may cause bacteria to accumulate and may also interfere with chewing. In addition, spicy or salty foods may cause pain in a dry mouth. You can minimize the effects of dry mouth by sipping water or sugarless drinks often; avoiding caffeine, tobacco, and alcohol; using a small squirt of lemon in the mouth or sugarless lemon candies to stimulate the parotid glands (which control saliva); using a humidifier at night; and using special products available in pharmacies to moisten dry mouth.

Dental Visits and MS

Plan to handle the challenges of fatigue, poor balance, spasticity, and/or transportation issues by finding out ahead of time whether the office building is sufficiently accessible. Make your special needs known to the office staff before your appointment. Determine whether the office has a dental chair that is sufficiently accessible for you (keep in mind that people who use wheelchairs may need other types of assistance as well).

Get some extra rest beforehand to compensate for the traveling and the office visit. Schedule visits for a time of day when you usually feel the most rested. Plan to rest upon returning from the dental visit.

The Truth About Mercury Amalgam

Over the years, claims have existed that mercury leaking from amalgam dental fillings damages the immune system and causes a broad range of diseases, including MS. While this disease's cause remains unknown, there is no scientific evidence that heavy-metal poisoning is responsible for the onset or worsening of MS. There is no reason to have your dental fillings removed or replaced. This is a very expensive procedure with no proven benefit for people with MS.

Information in this article is from the brochure "Dental Health: The Basic Facts," [C] 2005 National Multiple Sclerosis Society. Used by permission. For a complete copy of this brochure, which includes a list of dental-care resources for people with disabilities, call the National MS Society, (800)-FIGHT MS ([800] 344-4867), or visit www. nationalmssociety .org. Click on "Library" on the home page, then "Brochures," then "Staying Well," which will take you to "Dental Health: The Basic Facts." The author is attending dentist, clinical assistant professor, Special Care Treatment Center, Department of Pediatric Dentistry, New Jersey Dental School, University of Medicine & Dentistry of New Jersey.
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Title Annotation:diagnosis MS
Author:Andreen, Aviva L.
Publication:PN - Paraplegia News
Geographic Code:1USA
Date:Aug 1, 2005
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