Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Abstract

clinical rationale for the study. Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined. Aim of the study. The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS. Material and methods. 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records. results. The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist's surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010). conclusions and clinical implications. Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care.

Down-modulation of functional ventral striatum activation for emotional face stimuli in patients with insula damage

“…What is more, identifying impairments in autonomic arousal might be further aggravated by a generally reduced response in older participants [ 50 ]. However, an absent correlation between SCR and age in our stroke cohort could reflect impaired autonomic arousal and was also reported in previous work on stroke patients [ 56 ]. Looking at individual values showed that a null correlation was primarily driven by lowered SCR amplitudes in the younger patients of our sample compared to HCs of a similar age.…”

Multiple Sclerosis: Impact on Oral Hygiene, Dysphagia, and Quality of Life

“…Clinical symptoms of MS include motor deficits, vision deficits, bulbar symptoms, cognitive dysfunctions, and mental disturbances, which might interfere with oral hygiene. Furthermore, the progressively increasing functional disability, in association with the drugs used for MS, can cause a greater incidence of pathologies in the mouth and teeth [15].…”

Hyperventilation and Seizures: Not a New Sense: A Literature Review

“…The autonomic nervous system that acts as an unconscious control of respiration, cardiac regulation, vasomotor activity, and some reflexive actions has been shown to be dysfunctional in a subset of patients with epilepsy. 19 The sympathetic division of the autonomic nervous system is involved in the well-known fight or flight response. A study that investigated the sympathetic response to HV by looking at heart rate responses found that patients with mesial temporal lobe epilepsy showed increased sympathetic responses to HV compared to healthy subjects.…”