22 Multiple Sclerosis patients, while no differences were found in decayed, missing or filled teeth, it was noted that Multiple Sclerosis patients had higher prevalence rates for trigeminal neuralgia and symptoms of Temporomandibular Joint (TMJ) dysfunction.
Finally, in a study of gingival overgrowth and plaque induced gingivitis, Hefti (1994) observed very poor levels of oral health (high frequencies of plaque and gingivitis) in a sample of Multiple Sclerosis patients. It was stated that:
The results may be explained by the generally poor oral hygiene of the participants...reflecting a lack of manual dexterity often observed with Multiple Sclerosis patients (p. 744)
Thus, poor oral health in Multiple Sclerosis patients is, in part, explained not by the disease but by the disabling effects of the condition and the limitations it presents to patients practice of dental hygiene. The next section of this paper examines various considerations attendant to maintaining oral health in Multiple Sclerosis populations.
Given that Multiple Sclerosis causes debilitation in strength, sensation, vision, coordination, speech, and swallowing (Schapiro, 1998), it can easily be seen that individuals with the condition can have varying levels of difficulty carrying out those practices and procedures that are involved in achieving optimal dental hygiene. Indeed, in early research, it was estimated that 85 percent of all Multiple Sclerosis patients were not provided with the resources (e.g., education, protheses, books, pamphlets, cleansing agents, etc.) that they needed in order to maintain optimal oral health (Firnhaber & Orth, 1977). And, although a great deal more is known today regarding the needs of Multiple Sclerosis with respect to oral health, there has literally been no current research to examine whether more of these resources are being provided to Multiple Sclerosis patients today.
The question therefore becomes: What is require...