Multiple sclerosis (MS) can directly and indirectly affect a person’s mouth and oral health. Oral symptoms, including mouth sores and gum pain, affect between 2 percent and 3 percent of people with MS. Symptoms of MS, its common complications, or even medications used to treat MS can cause or worsen problems in the mouth.
If you’re living with MS, it’s important to recognize common oral symptoms and how they may develop. Read on to learn more about how people with MS can manage (and hopefully prevent) mouth sores and gum pain.
The relationship between MS and oral health runs in a cycle. Infections, inflammation, and some injuries — all of which can occur in the mouth — may trigger MS flares in some people. And no matter the cause, when MS symptoms show up, they can make it hard for a person to properly and regularly brush and floss. In turn, poor dental hygiene leads to inflamed sores, oral infections, irritated gums, and more. And the cycle goes on and on.
The systemic inflammation related to MS can directly affect nerves in the mouth and face — gums included. Inflammation can also affect the bones, nerves, mucous membranes, and skin in and around the mouth. Such inflammation often results in pain, sensory changes, mouth ulcers (oral lesions), and other issues.
In MS, autoimmune attacks on the central nervous system (CNS) damage the myelin that protectively coats neurons (nerve cells). This damage results in lesions that can develop on the brain, spinal cord, and optic nerve.
Neuropathic pain, also called neuralgia, is pain caused by nerve damage or pressure. As many as 1 in 4 people with MS experience neuropathic pain. This pain ranges from dull and throbbing to sharp and stabbing.
Trigeminal neuralgia (TN), or tic douloureux, is a common neuralgia that can develop in people with MS. (One Italian study of 130 people with MS showed they were 20 times more likely to develop TN than the general population.) The trigeminal nerve connects the brain with the face and communicates sensations of pain, temperature, and touch. Damage to this nerve results in TN, and the condition creates severe pain in the lower jaw, teeth, and gums. Something as innocent as brushing your teeth can trigger TN symptoms.
Periodontal (gum) disease and dental caries (cavities) are more common in people with MS compared with the general population. Why? The above challenges of MS make good oral hygiene hard to manage.
Several drugs used to manage MS come with possible side effects that can cause or contribute to oral sores and pain. One group of researchers in Australia set out to confirm just that. They combed through drug guides and databases looking for listed and flagged side effects for common medicines for people with MS. The results? They saw that yes, some disease-modifying therapies (DMTs) and drugs used to manage MS symptoms came with oral side effects.
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Still, not everyone reacts to the same medication in the same way. Some side effects pop up regularly. Others rarely occur at all. One person might experience none of the potential side effects linked to a medication. Another person might wrestle with a handful of them. Besides that, always remember: When a medication’s fact sheet mentions a long list of side effects, it doesn’t mean you will get every last one of them.
Some of the gum and/or mouth problems associated with DMTs for MS include:
The Australian team of doctors also found oral side effects listed for some medications used to treat MS symptoms. Some of those drugs include:
Corticosteroids (or simply steroids) like prednisone are often used to treat MS flares. Steroids raise a person’s risk for developing fungal infections, including oral yeast infections (candida). This is especially true when steroids are taken for a long time.
Oral sores and gum pain can crop up as symptoms in other health conditions, including autoimmune (AI) disorders. People with MS are more likely to develop other AI conditions. And some of those AI diseases count mouth sores and gum pain among their possible symptoms.
Some AI disorders that cause oral problems include:
Managing and treating gum pain and mouth sores largely depends on their root cause (or causes). If you have oral symptoms that don’t go away — or get worse — let your health care provider know. They can determine the cause and recommend appropriate treatment and prevention plans.
The old adage “Prevention is better than cure” applies to people with MS who have mouth and gum problems. And the best preventative measure? Making good oral hygiene a priority.
Some of the changes make it easier for someone with MS to maintain good oral hygiene include:
There are many ways to treat and control mouth sores and gum pain. Those options include both simple, at-home solutions and medical ones.
Consider addressing your oral ulcers and gum pain with these tips:
Manage dry mouth by:
Communicate honestly and regularly with your dentist and/or MS treatment provider. That helps to identify problems early and sort out the best way to deal with your mouth sores and gum pain.
On MyMSTeam, the social network for people with MS and their loved ones, you’ll find more than 184,000 members. Here, the MS community comes together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.
Do you get mouth sores or experience gum pain with MS? What tips do you have to manage symptoms and keep up with oral hygiene? Share your experiences in the comments below, or start a conversation by posting on your Activities page.