Multiple Sclerosis Dental Implants

Multiple Sclerosis Dental Implants

Multiple sclerosis is a neurological disease that causes inflammatory changes in parts of the central nervous system (brain and spinal cord). It usually occurs between the ages of 20 and 40, with women being affected about twice as often as men.

According to the current state of research, multiple sclerosis is an autoimmune disease. This means that your own immune system, whose main task is to fight off infections, is falsely directed against certain structures in your own nervous system. Components of the so-called “white matter” of the brain and the spinal cord, which are called myelin sheaths, represent points of attack for a misdirected inflammatory reaction. These myelin sheaths serve as an insulating layer around the nerve cell extensions (axons), via which information is transmitted throughout the nervous system. A violation of this isolation layer hinders the transmission of information, which leads to the clinical disturbances noticed by those affected.

Multiple Sclerosis and Dental Health
Multiple sclerosis (MS) patients are at risk of having problems in their mouth. A study shows that their risk of tooth decay, tooth loss or fillings increases by 9% compared to the normal population. The reasons for this can be difficulties in brushing your teeth every day. In addition, MS is known to cause dry mouth and bleeding from the gums, which also effects your oral health and can cause tooth decay and loss. If you have been diagnosed with MS, perhaps the last thing that you may think about is visiting your dentist, but a dental visit and a discussion with your dentist should be on your list of appointments, so as to try and avoid some of the oral issues that arise from the disease. It is important that you let your dentist know prior to the appointment that you have MS and ask for any comfort accommodations they might be able to provide.

If you have diseased or dead teeth, regardless of whether or not they are a result of MS, it is important that this is treated, as sick teeth can affect your whole long-term health. Additionally, part of managing your MS will be eating a healthy diet, which is made more difficult if you are missing teeth. If you are missing teeth at the time of diagnosis, or if you loose teeth in part because of the disease, it is important to know what options you have for teeth replacement.

Teeth Replacement options for MS patients
Oftentimes, dentures are contraindicated for people who have MS. This is due to the fact that dentures will wear on your sensitive gum tissue and on the bone structure in your jaw, and this can cause pain. Additionally, the everyday care of dentures may be inconvenient for you if you struggle with certain tasks, making it harder to keep them clean and in good shape. Historically, implants have also been contraindicated for patients with MS, but with care and coordination between your doctor and dental surgeon, implants might very well be the best way to replace your missing teeth..

Dental Implants
The insertion of implants is usually done under local anesthesia and is carried out on an outpatient basis. If the patient needs several implants, they can also be inserted in one session. Implants require enough bone mass in order to make the implant successful, and oftentimes there is an additional bone graft surgery that is involved in the process as well. Because surgery and anesthesia is involved in implants, it is important to discuss the procedure with your doctor and dentist to ensure that you are healthy enough for anesthesia and surgery. Local or general anesthesia, such as surgical intervention, does not present any particular risk for the patient with MS, but caution is imperative. In order to plan for your implants, a detailed understanding of the implant process is important as well.

Step 1: Preoperative planning
A repertoire of highly developed technical devices is used in modern dental practices and maxillofacial surgery clinics to optimally determine the patient’s initial situation. For example, the entire jaw can be scanned using a three-dimensional X-ray device. This so-called dental volume tomograph includes a 3D recording mode as well as a special navigation system with which absolute security can be guaranteed when planning the individual treatment steps. Further advantages are obvious: thanks to the volume tomograph, the risk of damage to nerve tracts in the jawbone can be drastically reduced, as any structures can be mapped in detail. In addition, the volume tomograph has 90 percent less radiation exposure than conventional X-ray machines. Based on the three-dimensional images of the teeth and jaw, the attending physician can plan the exact positioning of the implants and prepare a template for precise insertion.

Step 2: Implantation
Not only the planning, but also the implantation itself is done using computer navigation. The dentist first gains access to the jawbone with a small incision in the gum (minimally invasive). In the second step, he carefully drills a small, precisely fitting opening in the jaw, into which the titanium or ceramic screw is now inserted. After inserting the implant, the opening in the gum above the screw is closed with a few stitches. The healing phase now begins. This process is usually painless.

Healing phase
Once the implant has been placed in the upper jaw, the healing phase can take 3 to 6 months. With an implant in the somewhat more stable lower jaw, this process only takes 2 to 4 months. During this time, the implant grows together completely with the jawbone and forms a unit with it (osseointegration). Until the final replacement of the dental prosthesis, the patient wears an intermediate restoration, which nowadays is also fixed and aesthetically very appealing. Concerns about having to make do with an inadequate temporary restoration during the healing phase are therefore completely unfounded today.
Use of the permanent dentures
Once the healing process is complete, the gums are prepared for the future dentures. It should enclose him like a real tooth. For this purpose, the gums are opened again, and the implant receives a kind of small post, the gum former. Now an impression is taken, which the dental technician uses to manufacture the tooth replacement. After about 14 days, this “placeholder” is removed, and the actual dentures are firmly anchored on the implant. For the patient, there is no noticeable difference to real teeth in daily use.

Aftercare
Even if the intermediate restoration used is extremely stable, patients should be careful, especially in the first days after the procedure, not to put too much strain on the region and to use a soft brush for dental care. Swelling and slight pain may occur in the first few days, but these can be treated well with medication and icing the area. An antiseptic mouthwash during the first week after the procedure will help prevent inflammation. The healing phase itself takes 2 to 3 months, depending on whether the implant was placed in the upper or lower jaw. Only when the jawbone has completely attached to the implant can the patient have the actual denture attached.