Dental and Medical Problems
2020, vol. 57, nr 1, January-March, p. 25–29
Publication type: original article
Salivary profile and dental status of patients with multiple sclerosis
Profil ślinowy i stan uzębienia pacjentów ze stwardnieniem rozsianym
1 Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Periodontics, School of Dentistry, Qazvin University of Medical Sciences, Iran
3 Department of Neurology, Neuroscience Institute, MS Research Center, Tehran University of Medical Sciences, Iran
4 Department of Prosthodontics, School of Dentistry, Qazvin University of Medical Sciences, Iran
5 Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Background. Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. The MS patients may display biochemical changes in their cerebrospinal fluid, peripheral blood and saliva. Since the salivary profile plays a critical role in maintaining oral health and function, the analysis of saliva in the MS patients would be beneficial to prevent oral diseases, such as dental caries.
Objectives. The aim of this study was to evaluate the dental status and salivary profile of the MS patients.
Material and Methods. The study involved 25 MS patients and 25 healthy controls who were examined with regard to the calcium and phosphorus level, pH and flow rate of saliva as well as the decayed, missing and filled teeth (DMFT) index for permanent first molars. Student’s t-test, the χ2 test and the Mann–Whitney test were utilized to compare the study groups.
Results. Significantly lower salivary flow rates were observed in the MS patients as compared to the controls. The salivary calcium and phosphorus levels were significantly higher in the case group during the first 6 years of the disease and 6–11 years after the onset of the disease, respectively, in comparison with the controls; however, there was no significant difference between the groups in terms of pH. The DMFT index for permanent first molars was higher in the MS patients than in the healthy controls, but not significantly. The number of carious and missing permanent first molars was significantly higher in the MS patients.
Conclusion. Multiple sclerosis appears to significantly change the salivary profile and dental status of the patients.
multiple sclerosis, DMFT, salivary profile
stwardnienie rozsiane, DMFT, profil ślinowy
- Leray E, Moreau T, Fromont A, Edan G. Epidemiology of multiple sclerosis. Rev Neurol (Paris). 2016;172(1):3–13.
- Gallud L, Bagan JV, Cervelló A, Jiménez Y, Poveda R, Gavalda C. Multiple sclerosis as first manifestation in oral and facial area: Presentation of four cases. Med Oral Patol Oral Cir Bucal. 2006;11(2):E141–E145.
- Chałas R. Calcium and potassium saliva concentration in patients with multiple sclerosis. Acta Stomatol Croat. 2009;43(1):34–38.
- Santa Eulalia-Troisfontaines E, Martínez-Pérez EM, Miegimolle-Herrero M, Planells-Del Pozo P. Oral health status of a population with multiple sclerosis. Med Oral Patol Oral Cir Bucal. 2012;17(2):e223–e227.
- Feinstein A. Multiple sclerosis and depression. Mult Scler. 2011;17(11):1276–1281.
- Fiske J, Griffiths J, Thompson S. Multiple sclerosis and oral care. Dent Update. 2002;29(6):273–283.
- Navazesh M, Kumar SK. Measuring salivary flow: Challenges and opportunities. J Am Dent Assoc. 2008;139(Suppl):35S–40S.
- Khan AA. The permanent first molar as an indicator for predicting caries activity. Int Dent J. 1994;44(6):623–627.
- Becker T, Levin L, Shochat T, Einy S. How much does the DMFT index underestimate the need for restorative care? J Dent Educ. 2007;71(5):677–681.
- Etemadifar M, Sajjadi S, Nasr Z, et al. Epidemiology of multiple sclerosis in Iran: A systematic review. Eur Neurol. 2013;70(5–6):356–363.
- Hernán MA, Zhang SM, Lipworth L, Olek MJ, Ascherio A. Multiple sclerosis and age at infection with common viruses. Epidemiology. 2001;12(3):301–306.
- Polliack ML, Barak Y, Achiron A. Late-onset multiple sclerosis. J Am Geriatr Soc. 2001;49(2):168–171.
- Harbo HF, Gold R, Tintoré M. Sex and gender issues in multiple sclerosis. Ther Adv Neurol Dis. 2013;6(4):237–248.
- Cockburn N, Pateman K, Taing MW, Pradhan A, Ford PJ. Managing the oral side-effects of medications used to treat multiple sclerosis. Aust Dent J. 2017;62(3):331–336.
- Cockburn N, Pradhan A, Taing MW, Kisely S, Ford PJ. Oral health impacts of medications used to treat mental illness. J Affect Disord. 2017;223:184–193.
- Sandberg-Wollheim M, Axéll T, Hansen BU, et al. Primary Sjögren’s syndrome in patients with multiple sclerosis. Neurology. 1992;42(4):845–847.
- Miró J, Peña-Sagredo JL, Berciano J, Insúa S, Leno C, Velarde R. Prevalence of primary Sjögren’s syndrome in patients with multiple sclerosis. Ann Neurol. 1990;27(5):582–584.
- de Seze J, Devos D, Castelnovo G, et al. The prevalence of Sjögren syndrome in patients with primary progressive multiple sclerosis. Neurology. 2001;57(8):1359–1363.
- Baliga S, Muglikar S, Kale R. Salivary pH: A diagnostic biomarker. J Indian Soc Periodontol. 2013;17(4):461–465.
- Marcus JF, Shalev SM, Harris CA, Goodin DS, Josephson SA. Severe hypercalcemia following vitamin D supplementation in a patient with multiple sclerosis: A note of caution. Arch Neurol. 2012;69(1):129–132.
- Arbabi-Kalati F, Sandoghi M, Moradi M, Salimi S. Relationship between bone density and salivary calcium in women with rheumatoid arthritis undergoing corticosteroid therapy. Dent Clin Exp J. 2016; [in press]: e11432.
- Gupta S, Ahsan I, Mahfooz N, Abdelhamid N, Ramanathan M, Weinstock-Guttman B. Osteoporosis and multiple sclerosis: Risk factors, pathophysiology, and therapeutic interventions. CNS Drugs. 2014;28(8):731–742.
- Kampman MT, Eriksen EF, Holmøy T. Multiple sclerosis, a cause of secondary osteoporosis? What is the evidence and what are the clinical implications? Acta Neurol Scand. 2011;124(Suppl 191):44–49.
- van Amerongen BM, Feron F. Effect of high-dose vitamin D3 intake on ambulation, muscular pain and bone mineral density in a woman with multiple sclerosis: A 10-year longitudinal case report. Int J Mol Sci. 2012;13(10):13461–13483.
- Kubicka-Baczyk K, Labuz-Roszak B, Pierzchala K, Adamczyk-Sowa M, Machowska-Majchrzak A. Calcium-phosphate metabolism in patients with multiple sclerosis. J Endocrinol Invest. 2015;38(6):635–642.
- Mohammad Shirazi M, Taleban F, Ghafarpoor M. Comparison of micronutrient intake in multiple sclerosis patients in Tehran with the recommended doses. Iran J Epidemiol. 2006;2(1–2):27–34.
- Kovac Z, Uhac I, Buković D, Cabov T, Kovacević D, Grzić R. Oral health status and temporomandibular disorders in multiple sclerosis patients. Coll Antropol. 2005;29(2):441–444.
- McGrother CW, Dugmore C, Phillips MJ, Raymond NT, Garrick P, Baird WO. Multiple sclerosis, dental caries and fillings: A case-control study. Br Dent J. 1999;187(5):261–264.
- Hatipoglu H, Canbaz Kabay S, Gungor Hatipoglu M, Ozden H. Expanded disability status scale-based disability and dental-periodontal conditions in patients with multiple sclerosis. Med Princ Pract. 2016;25(1):49–55.
- Fragoso YD, Carvalho Alves HH, Carvalho Alves L, Carvalho Alves N, Siqueira de Andrade CM, Finkelsztejn A. Dental care in multiple sclerosis: An overlooked and under-assessed condition. J Disab Oral Health. 2010;11(2):53–56.