Multiple Sclerosis

Question 1

Describe multiple sclerosis, its effects (4), who it affects most, its etiology and how frequent attacks are

Answer 1

Description
• T-cell mediated autoimmune disease that affects myelin sheath in the central nervous system (CNS), leaving scar tissue behind

Effect:
• Results in motor, sensory, cognitive & emotional changes (interference with nerve impulses)
• Physical impairment varies but worsens with each episode

Who is most affected:
• More common in women and those aged 20 and 40

Etiology:
• Etiology: unknown but genetically linked

How frequent attacks are:
• Attacks may last days to weeks
• Symptom-free periods which may last several years

Question 2

List the precipitating factors for a multiple sclerosis attack (6)

Answer 2

• Fatigue
• Infections (oral ones to)
• Stress
• Heavy exercise
• Injury
• Pregnancy

Question 3

List the general signs and symptoms of multiple sclerosis (8)

Answer 3

• Visual impairments
• Speech disorders
• Coordination & balance difficulties
• Tremors
• Fatigue
• Weakness
• Transient tingling paresthesia of hands or feet
• Severe illness: sudden paralysis or marked weakness

Question 4

List the oral signs and symptoms of multiple sclerosis due to medications (3)

Answer 4

• Corticosteroids: Increased infections
• Methotrexate: mouth ulcers, bleeding gums
• Poor OHI due to mobility issues

Question 5

List the medications used to treat multiple sclerosis (3)

Answer 5

• Corticosteroids
• Interferon Beta
• Methotrexate

Question 6

Explain the overall dental management for multiple sclerosis (5)

Answer 6

• Provide in warm, quiet, comfortable & relaxed atmosphere
• Short & frequent appointments
• Slow & simple instructions
• Prevent periodontal infections
• For tongue & facial muscles involvement, consider the use of adaptive home care aids