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Providing Evidence-based Oral Health Care to Individuals Diagnosed with Degenerative Disorders, Part 1: Multiple Sclerosis
Appointment Management Considerations

Course Author(s): Melanie Simmer-Beck, RDH, PhD

Appointment Management Considerations

  • Elective dental treatments should be postponed during exacerbations or flare ups of MS symptoms.47
  • Individuals diagnosed with MS are at elevated risk for caries due to xerostomia, fatigue, dexterity limitations, and muscle dysfunction of the oral cavity.
  • Oral self-care instructions should be based on the patient’s functional ability and values.
  • Cigarette smoking has been shown to increase risk of disease progression transforming from RRMS to PPMS and to exacerbate symptoms. Tobacco cessation is critical for this population.
  • Cool and stress free environments may aid in reduction of exacerbated symptoms.
  • Frequent and shortened morning appointments may be better for patients with MS.47
  • Wheelchair accessibility may be required in order to treat patients with more progressive disease symptoms. Consider providing oral health services to patients directly in their wheelchair if a patient cannot transfer from their wheelchair into the dental chair.
  • Patients may require frequent bathroom breaks due to incontinence. Using an operatory near a restroom can make frequent breaks easier on the patient.
  • Plan short appointments for patients who experience trigeminal neuralgia or facial discomfort. The shooting pain and discomfort brought on by dental procedures can become too arduous for patients.
  • Always note extra-oral findings of facial nerve pain in a patient’s dental record. Refer patient to a physician immediately if patients report facial pain that cannot be explained. Dental professionals are at an advantage to detect early MS symptoms.
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