An update on myasthenia gravis, challenging disease for the dental profession

Abstract

Myasthenia gravis is an autoimmune neuromuscular disorder characterized by fluctuating weakness and skeletal muscle fatigue. Clinical signs and symptoms may vary considerably according to the age at presentation, patterns of autoantibodies and associated thymic abnormalities, so that therapeutic options are highly individualized. Facial and oropharyngeal muscle weakness is common at disease onset, and therefore dentists are often the first health professionals to encounter these patients. Myasthenic patients require special consideration and advice in order to ensure optimal and safe dental treatment. Oral manifestations, treatment timing and modality, the choice and effects of drugs and medications, and prevention of myasthenic crisis are all important aspects with which dentists and oral health care providers should be thoroughly acquainted. (J Oral Sci 57, [161][162][163][164][165][166][167][168] 2015)

Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

“…Oral function evaluation may help confirm the effectiveness of treatment, and predict future general-health deterioration [ 8 ]. It is also known that decreased oral function is a prodromal symptom of severe diseases including neuromuscular conditions [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. It is clearly important to conduct oral function examinations on a broad range of patients, since they have the potential to incidentally detect severe diseases at an early stage.…”

A comprehensive review of the neonatal Fc receptor and its application in drug delivery

“…such as systemic lupus erythematosus, neuromyelitis optica (Brimberg et al, 2015), myasthenia gravis (Tamburrini et al, 2015), type 1 diabetes (Leslie et al, 2015) and hepatitis (Sener, 2015), among many others.…”

Anesthetic considerations for a patient with myasthenia gravis undergoing deep sedation in an outpatient oral surgery setting

“…A number of drugs and anesthetics regularly used in dentistry and oral surgery are contraindicated with MG patients due to the increased risk they present in exacerbating the MG-associated muscular symptoms [1]. Drugs that interfere with neuromuscular transmission or cause respiratory depression, thereby increasing the risk of myasthenic crisis, are to be avoided [911].…”

“…Myasthenia gravis (MG) is an autoimmune disease of neuromuscular origin whose typical clinical manifestations include symptoms such as skeletal muscle weakness and increased fatigue upon exertion [1]. Early symptomatic signs indicative of MG are typically localized to the ocular, ophthalmic, and facial muscle groups; patients can present with diplopia, photophobia, ptosis, weakness of the orbicularis oculi, dysphagia, poor mastication as a result of weak masseter muscles, and possibly a hoarse speaking voice due to vocal cord paralysis [2].…”