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I just had a tooth pulled two weeks ago. What started out as a routine root canal turned into something more. My endodontist tried to save the tooth but couldn’t. He sent me to an oral surgeon with the news I’d have to have the tooth extracted. 

People are more nervous about having dental work than they ought to. I understand this, but if you find the right dental team, you will be in good hands. For instance, if you need to be calmed down, nitrous oxide (laughing gas) can be an option. When or if you need to have a tooth pulled, they now have three-day Novocain that can lessen the discomfort immensely. The first three days after having oral surgery are usually the worst, so having this extended-release Novocain will keep you comfortable and reduce the need for taking opioids. I’m grateful for this and was able to function quite well after my surgery. 
 

• MS and other chronic illnesses can have a harsh effect on our oral health. “To have good oral health, we need good manual dexterity to brush and floss properly. People with MS are not always able to do this very well.
• Fatigue and mobility problems can interrupt oral health.
• Don’t just focus on your MS-related symptoms.
• Facial pain (trigeminal neuralgia) can cause problems or interruptions with a regular oral health regime. See the Journal of Oral Maxillofacial Surgery for more.
• Some medications used to treat MS symptoms – or others such as anxiety and allergies – can cause dry mouth and bacteria accumulation. 

There are studies that show that people with MS have high rates of tooth decay (dental caries) and periodontal disease (gum disease). These will affect our oral health in a number of ways. 

When our mouth, gums, and teeth are not in good condition, eating and digesting healthy, nutritious foods becomes more challenging. Poor hygiene may lead to infection which can worsen MS symptoms as well as our self-esteem.

There are several medications that can lead to negative consequences in oral health. Dry mouth is one of the most common. I feel like dry mouth is what led me towards my own situation in having to have my tooth extracted. I find myself waking up at night with dry mouth and throughout the day. I do keep myself hydrated and drink water as often as possible, but because I have allergies, my use of Benadryl and other meds can be problematic. 

There are several drugs that cause dry mouth. Talk to your doctors and your dental team to see what these are and how to protect your teeth and gums. 

If your medications are causing dry mouth, these tips may help:

• Regularly sip water and sugarless beverages.
• Avoid caffeine, tobacco, and alcohol (if you do, drink these, then add more water as needed).
• Check to see if you might have other conditions such as Sjogren’s 
• Use over-the-counter dry mouth supplements such as Biotene rinse and losenges.
• Alcohol-based rinses will only escalate dry mouth, so avoid them. 
• Brush and floss, see your dentist regularly, and follow instructions as needed.

Long story short, find a good dentist, tell them about your MS, the meds you are taking, and come up with a good plan for your oral hygiene to save your teeth and your health.