Many MS medications aim to even out and control the immune system. These medications end up causing dry mouth (xerostomia), swollen gums (gingival hyperplasia), oral ulcers (ulcerative stomatitis), oral thrush (candidiasis), and reactivation of the herpes viruses.
In some cases, an individual can develop oral thrush, which causes creamy white lesions to form on the tongue.
Patients who have MS sometimes lack saliva. Dry mouth makes chewing, swallowing, and speaking more difficult. It can also lead to tooth loss because saliva isn't helping wash away decay-causing food residue and bacteria. Patients with advanced MS often have trouble swallowing.
MS patients may have lesions of the brainstem affecting the direct nerve supply to the tongue and throat muscles. More commonly in my experience, multiple lesions (MS plaques) involving both cerebral hemispheres of the brain cause a lack of coordination of the tongue and throat swallowing muscles.
A study by Spanish researchers showed that people who have MS have high rates of dental caries (tooth decay) and periodontal (gum) disease. These problems can impact overall health in a number of ways. “Good oral hygiene has been shown to be very important,” says Kashani.
Socket sclerosis is usually asymptomatic and does not require any treatment. The only potential complication arises during orthodontic treatment, wherein sclerosed socket of the premolar teeth may be an obstacle in closing the space by movement of teeth through the extraction space.
Individuals with MS are at increased risk for dental caries, gingivitis and periodontitis due to the physical effects of MS, as well as these patients' reduced immune response.
Oral Lichen Planus: This oral autoimmune disease occurs when the immune system attacks the mucous membranes inside your mouth, according to The Mayo Clinic. It will appear as lacy white patches, sometimes accompanied by painful sores on the lining of the cheeks, tongue, and gums.
Associated Difficulties – Excessive Saliva
Some people may find they have more saliva in their mouths than they can manage. This is not the result of increased saliva production, but of lip, cheek and tongue weakness and less frequent swallowing. This can cause drooling.
Numbness of the face, body or extremities (arms and legs) is one of the most common symptoms of MS. It may be the first MS symptom you experienced. The numbness may be mild or so severe that it interferes with your ability to use the affected body part.
Oral Lichen Planus Reason: Oral lichen planus is a chronic inflammatory condition caused by an autoimmune response. It can result in a coated tongue, yet the coating appears as a lace-like white pattern.
A white tongue is usually caused by a white coating over the tongue. The coating can be due to a buildup of dead cells on the surface of the tongue, food residue, or an overgrowth of bacteria. It can also be from dried and caked saliva, damaged tongue tissues, or a combination of all of these things.
Iron deficiency anemia or pernicious anemia – A pale (almost white), smooth tongue can be caused by a deficiency in iron or vitamin B12.
Migraines are one of the most common mimicker diseases that can be misdiagnosed for MS. Migraine causes intense throbbing headaches, light sensitivity, and nausea. Many migraine sufferers have also experienced blurred vision similar to the kind caused by optic neuritis in MS patients.
These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
People with Sjogren's syndrome are much more likely to develop oral thrush, a yeast infection in the mouth.
Disorders of the 12th cranial nerve (hypoglossal nerve) cause weakness or wasting (atrophy) of the tongue on the affected side. This nerve moves the tongue. Hypoglossal nerve disorders may be caused by tumors, strokes, infections, injuries, or amyotrophic lateral sclerosis.
Vitamin B deficiencies are one of the most common deficiencies that can affect mouth and teeth. A common oral effect of vitamin B deficiency is a burning sensation in the mouth, especially on the tongue. People with this deficiency can also have trouble swallowing. The tongue may feel swollen.
Conclusions and clinical implications: Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS.