Multiple Sclerosis and Dry Mouth
Yes, multiple sclerosis can cause dry mouth (xerostomia), with studies showing it affects up to 43.2% of MS patients, particularly those with more advanced disease progression. 1
Mechanisms of Dry Mouth in MS
- Neurological involvement, particularly in the brainstem, can affect nerves controlling salivary gland function, leading to altered salivary production in MS patients 2
- Dysphagia-related issues affect approximately 32% of MS patients with permanent dysphagia, contributing to perceived dry mouth symptoms 2
- Dry mouth is more prevalent in patients with secondary-progressive MS (SPMS) compared to relapsing-remitting MS (65.4% vs 41.3%) 1
- MS patients with longer disease duration are more likely to experience oral symptoms including dry mouth 1
Clinical Significance and Associated Conditions
- Dry mouth often co-occurs with dysphagia (swallowing difficulties) in MS patients, which affects approximately one-third of all MS patients 3
- Pharyngeal stage disorders are the most common swallowing impairment in MS (28.7%), with oral stage disorders observed in 5% of patients 3
- Patients with MS-related dysphagia have significantly longer disease duration, more neurological impairment in cerebellar functional systems, and greater neurological disability 3
- Screening for dysphagia is recommended in all MS patients with dry mouth, as these conditions frequently co-occur 2
Management Approaches
- Modifying food and fluid consistency can improve swallowing safety for MS patients with dysphagia and dry mouth 2
- For MS patients with dysphagia, the European Society for Clinical Nutrition and Metabolism (ESPEN) recommends using modified consistency foods and fluids to ensure safe swallowing, according to individualized patient needs 3
- For patients unable to meet nutritional needs orally, enteral nutrition therapy via PEG (percutaneous endoscopic gastrostomy) is recommended 3
- Daily oral hygiene may be limited in MS patients due to motor deficits, balance problems, and pain, requiring additional support and possibly electric toothbrushes 1
Important Considerations
- Dry mouth in MS patients may be exacerbated by medications used to treat MS symptoms, particularly anticholinergic drugs used for neurogenic overactive bladder 4, 5
- MS patients should be evaluated for other potential causes of dry mouth, including Sjögren's syndrome, which can co-occur with MS 6
- Regular dental care is essential but often challenging for MS patients, with studies showing that frequent dental visits are uncommon in patients with SPMS (12% vs 39.7% in RRMS) 1
- Oral health complications from dry mouth can significantly impact quality of life in MS patients and should be addressed as part of comprehensive care 7