Oral health and behaviours of people living with Multiple Sclerosis in Australia

Abstract

Objectives The literature describing the oral health of people with Multiple Sclerosis (MS) is scant and the findings equivocal. The aim of this study was to describe the oral health and oral self‐care behaviours of people living with MS and compare it to the Australian population. Methods Participants enrolled with the Australian MS Longitudinal Study (AMSLS) were invited to participate in the survey using an online or paper‐based questionnaire. Data were collected on level of disability, oral health, oral self‐care and factors influencing attendance for oral health care. Results Completed questionnaires were received for 1523 respondents. Over one‐fifth (n = 320; 22%) rated their oral health as fair or poor, and more than half (n = 840; 57%) reported toothache in the last 12 months. These proportions were higher than those for the general Australian adult population (oral health prevalence ratio (PR) = 1.25 [1.12, 1.40]; toothache PR = 3.63 [3.39, 3.88]), and this is despite comparable or better self‐maintenance habits and dental attendance reported by respondents. People with MS reported high rates of mouth dryness (68.4%), teeth sensitivity (64.7%), change of taste (40.5%) and orofacial pain (39.0%); fewer than 10% experienced none of these. There was a lower prevalence of self‐reported need for treatment (extraction or filling) than in the Australian adult population (15.8% vs 32.9%). Conclusions People with MS have a greater oral health burden, demonstrated by their poorer self‐reported oral health than the Australian adult population. Furthermore, they experience high rates of toothache, mouth dryness, teeth sensitivity, change of taste and orofacial pain. These findings are contrary to their self‐reported good oral self‐care and dental attendance habits and suggest some of the oral health impacts are due to MS rather than dental behaviours.

A systematic review of oral health in people with multiple sclerosis

“…For the three studies that did not include a control group, moderate to heavy plaque deposits were reported by more than 60.0% of people with multiple sclerosis in one, and a score of 1.30 was reported on the Plaque Index by Silness and Loe in another, indicative of only fair oral hygiene . Finally, in the third study, approximately one‐fifth of a large cohort of people with multiple sclerosis (22.1%) rated their oral health status as fair or poor, which was higher than figures reported in a large national survey of oral health (16.4%) . Taken together, there is suggestive evidence that multiple sclerosis may be associated with poorer oral hygiene.…”

“…The diagnosis of multiple sclerosis (reported in 13 of the 17 studies) was established using a range of standardized criteria: McDonald criteria (seven studies), Schumacher criteria (one study) and Poser criteria (one study). The International Classification of Diseases (ICD) criteria formed the basis for multiple sclerosis diagnosis in one study, while three other studies used medical reports (provided by physicians and neurologists), without mentioning the specific diagnostic criteria used . Four studies did not mention the classification used for diagnosis of multiple sclerosis .…”

“…Among these manifestations, estimates of trigeminal neuralgia ranged from 7.9% to 32.0% and facial palsy from 15.3% to 19.0%. Five studies assessed facial pain; this was reported by 9.0% to 72% of people with multiple sclerosis. In the two studies that included a control group, people with multiple sclerosis reported significantly greater oro‐facial pain, while in the study by Kovac et al, no significant differences were reported relative to controls.…”

“…Only one study measured teeth grinding and para‐functional habits; in this study, both of these symptoms were relatively more common for people with multiple sclerosis relative to controls. Another study identified toothache rates in people with multiple sclerosis to be approximately three times more common relative to the general population . Dysgeusia was reported in over 20.0% to 40.0% of people with multiple sclerosis .…”

“…Another study identified toothache rates in people with multiple sclerosis to be approximately three times more common relative to the general population . Dysgeusia was reported in over 20.0% to 40.0% of people with multiple sclerosis . Finally, xerostomia (a subjective feeling of a dry mouth) and teeth sensitivity were present in 68.0% and 64.7% of people with multiple sclerosis, respectively .…”