Multiple Sclerosis and Dry Mouth

Yes, multiple sclerosis (MS) can cause dry mouth (xerostomia), with studies showing it affects approximately 43% of MS patients. 1

Mechanisms of Dry Mouth in MS

Neurological involvement: MS can affect the nerves controlling salivary gland function, particularly when there is brainstem involvement, leading to altered salivary production 2
Dysphagia-related issues: Difficulty managing secretions affects approximately 32% of MS patients with permanent dysphagia, contributing to perceived dry mouth 2
Disease progression: Dry mouth is more prevalent in patients with secondary-progressive MS (65.4%) compared to relapsing-remitting MS (41.3%), indicating correlation with disease severity 1

Disease duration: Patients with longer MS duration experience more oral symptoms, including dry mouth 1, 3
Disability level: Higher disability scores on the Expanded Disability Status Scale correlate with increased oral symptoms 3
MS phenotype: Secondary-progressive MS patients have significantly higher rates of dry mouth compared to relapsing-remitting MS patients 1

Gingival inflammation: Bleeding gums affect approximately 28.1% of MS patients, often associated with longer disease duration 1
Oral hygiene difficulties: Patients with more advanced MS have significant challenges maintaining daily oral hygiene (24% in SPMS vs. 8.1% in RRMS) 1
Taste disturbances: MS patients report higher rates of taste alterations compared to healthy controls 3

Regular dental care: Frequent dental visits (at least every six months) are recommended but often challenging for patients with advanced MS 1
Adaptive oral hygiene tools: Electric toothbrushes should be considered for patients with motor deficits and balance problems 1
Modified food and fluid consistency: For MS patients with dysphagia and dry mouth, modifying food and fluid consistency can improve swallowing safety 2
Medication review: Evaluate medications that may contribute to dry mouth, particularly anticholinergic drugs often used for neurogenic bladder in MS 4, 5

Screening for dysphagia: All MS patients with dry mouth should be evaluated for dysphagia, as these conditions frequently co-occur 6
Monitoring disease progression: Dry mouth may indicate disease progression, particularly when accompanied by other bulbar symptoms 3
Quality of life impact: Dry mouth significantly affects quality of life in MS patients and requires proactive management 7

Oral health education: MS patients require specific education about proper oral hygiene techniques adapted to their physical limitations 1
Regular dental follow-up: Establishing consistent dental care is essential, with adaptations for patients with mobility challenges 1, 7
Early intervention: Addressing dry mouth symptoms early may prevent complications like dental caries and oral infections 5