The need for routine dental cleanings and care doesn’t go away when you have myasthenia gravis (MG) — but when even chewing and swallowing are a challenge, visiting the dentist might sound impossible. With a few extra steps, however, people with MG can still get dental care.
Why dental care is important in myasthenia gravis
Preventing problems before they start is the best way to take care of your oral health when you have MG.
Without routine dental care, small dental problems can quickly escalate into bigger ones — such as a cavity progressing to an infected root canal. These problems are not only bad for your overall health, but can mean more stress (aggravating your MG symptoms) and longer procedures that are harder to sit through.
Poor oral health can eventually mean you need dentures — but with MG, dentures aren’t a good option. Muscle weakness from MG makes it harder for your cheeks to hold the dentures in place. Struggling with dentures can also worsen MG symptoms.
People with MG are also more likely to get infections, especially if they’re taking immunosuppressants or steroids. That risk extends to oral infections, too.
For all these reasons, people with MG need to stay on top of their dental care.
Read more about MG treatment and care
Preparing for your visit to the dentist
If your symptoms are well-controlled, a handful of small changes can make routine visits to the dental office easier. (If you have more severe symptoms, however, you may need to receive dental care in a hospital setting.) These small steps start before you ever sit down in the dental chair:
- Communicate openly. Inform your dentist of your diagnosis before your visit. Explain in detail what your needs are; the Myasthenia Gravis Foundation of America has a helpful brochure you can share with your dentist.
- Be informed. Ask your healthcare team, especially your neurologist, for practical advice on managing your dental appointments. Learn what medications could interact with your treatments and should be avoided.
- Plan ahead. Book an appointment for the morning when you’re less likely to experience fatigue and muscle weakness. Ask a family member or friend to accompany you, to provide moral and physical support if you become fatigued.
- Prepare any questions ahead of time. Does your dentist have any tips for you to make life easier when living with muscle weakness for brushing, flossing and ensuring good dental hygiene?
Tips for during and after your visit
Working within your fatigue levels and easing stress can help make your visit a successful one:
- Ensure your physical comfort. Reclining in a dental chair can put pressure on your breathing, and if your throat muscles become fatigued, the risk of choking is higher. Sitting more upright can help. A mouth prop can help keep your mouth open during appointments with less strain.
- Keep visits short. Talk with your dentist about breaking care into several shorter visits. If your dentist finds a cavity during a cleaning, don’t be afraid to ask to have it filled another day even if your dentist has time to treat it immediately.
- Use rubber dams. Rubber dams are latex sheets that are used to protect the rest of your mouth during a dental procedure; for example, if you’re getting a root canal the dam might cover everything except the tooth being treated. This can help keep water and debris away from your airways.
- Stop if you need to. Even with preparation, you might find yourself feeling too weak. Tell your dentist when you need to stop the appointment.
- Rest. Ask your dentist for regular rest breaks. Plan to rest after your appointment, as well.
Anesthetics require extra caution
Some types of general anesthesia, sedation and muscle relaxants can interfere with neuromuscular transmission or risk a myasthenic crisis. Local anesthetics are therefore the better option for managing pain during treatment. Talk with your dentist about limiting how much of your mouth is numbed, so your tongue and jaw aren’t impacted more than necessary.
Sign up here to get the latest news, perspectives, and information about MG sent directly to your inbox. Registration is free and only takes a minute.
