Oral health status and temporomandibular disorders in multiple sclerosis patients

Autor: Kovač, Z., Ivone Uhač, Buković, D., Ćabov, T., Kovačević, D., Gržić, R.
Rok vydání: 2006
Předmět:
Zdroj: Collegium antropologicum
Volume 29
Issue 2
Scopus-Elsevier
ResearcherID
ISSN: 0350-6134
1848-9486
Popis: Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system1. MS is characterized by a relapsing-remitting or progressive course and a pathologic triad of CNS inflammation, demyelination, and gliosis (scarring). Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia (tic douloureux), sensory neuropathy of the trigeminal nerve (parasthesia) and facial palsy. The aim of this study was to determine oral health status, frequency of subjective symptoms and TMD subtype according to RDC/TMD among MS patients. Examinees in this study were 50 patients suffering from MS, who were treated during their disease for at least one time in Clinic Hospital Center Rijeka, Clinic for Neurology. All of the examinees had to meet diagnostic criteria for clinically and laboratory confirmed MS, according to Poser. Results shows difference in mean DMFT beetwen MS and control group. The number of decayed and missing teeth was higher, but number of filled teeth was significantly smaler in MS group. Eighty-two per cent of the subjects with MS had a least one symptoms of dysfunction compared with 24% of the subjects in the healthy control group. In the present study, pain, pain during mouth opening, difficulty with mouth opening and TMJ sounds were more commonly reported in the MS group than in control group. This study shows a statistically significant excess of dental caries and temporomandibular disorders among MS patients compared with control group. This results suggest that MS is possible etiological factor of temporomandibular disorders. Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system1. It is characterized by a relapsing-remitting or progressive course and a pathologic triad of CNS inflammation, demyelination, and gliosis (scarring). MS is a chronic, frequently progressive disease that predominently attacks the myelin sheath of the central nervous system (CNS - brain and spinal cord). Demyelination occurs, often with scarring at multiple sites throughout the CNS. It is hypothesized that an external "trigger" such as a virus may precipitate an autoimmune response in genetically susceptible individuals2-5. Lesions of MS are classically said to be disseminated in time and space. Manifestations of MS vary from a benign illness to a rapidly evolving and incapacitating disease requiring profound adjustments in life-style and goals for patients and their families. Complications from MS affect multiple body systems ; hence, a multidisciplinary approach is recommended to optimize clinical care. Symptoms vary widely, but most commonly include: gait disturbances, sensory complaints (numbness, paresthesias, burning, feelings of constriction or pain), visual problems, fatigue, incoordination, bladder, bowel and sexual dysfunction, and partial or complete paralysis in severe cases6-9. Mild cognitive impairment occurs in many patients with MS, while a smaller proportion (about 10%) experience serious intellectual deterioration. The cause and cure are unknown, although symptomatic management is possible and certain immunoregulatory agents reduce the relapse rate and may prove to slow disease progression. Since MS affects the whole body, orofacial aspects of the disease must be expected, particularly since loss of muscular coordination may result in a diminished ability to maintain oral hygiene10, 11. Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia (tic douloureux), sensory neuropathy of the trigeminal nerve (parasthesia) and facial palsy12-14. Trigeminal neuralgia usually appears after the diagnosis of multiple sclerosis has been made and is present in about 1.9% of cases. It is, however, the first manifestation of the disease in 0.3% of cases15. The aim of this study was to determine oral health status, frequency of subjective symptoms and TMD subtype according to RDC/TMD among MS patients.
Databáze: OpenAIRE
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