Multiple Sclerosis - A Practical Guide to Rehabilitation - 43

A Practical Guide to Rehabilitation
in
A PRACTICAL GUIDE TO IDIOPATHIC

MULTIPLE SCLEROSIS

Adequate levels of saliva production are critical
not only for a healthy mouth, but overall physical
health. Saliva moistens the mouth and throat;
facilitates speech; and aids in taste, swallowing,
digestion, and washing food and plaque off the
teeth and out of pockets in the mouth. In
addition, saliva neutralizes acids in the mouth
and helps to heal mouth injuries.
Xerostomia, also known as "dry mouth," results
from decreased or lack of saliva production. It is a
symptom, not a disease. Xerostomia can affect
both hard and soft tissues in the mouth, and
decreased saliva increases the risk of caries, fungal
infections, and periodontal disease.170,171 Factors
that increase risk of xerostomia include decreased
oral intake, dysphagia, oral infections, and
infections in other parts of the body.170
Signs and symptoms of xerostomia include:170
* Excessive thirst
* Decreased taste
* Burning/tingling sensation of the mouth
and/or tongue
* Red, raw tongue
* Sores in the mouth or at the corners of the lips
* Dry, cracked lips
* Difficulty swallowing
* Sore throat/hoarseness
* Bad breath
* Speech problems, including slurred speech
* Dry nasal passages
* Difficulty wearing dentures

Good oral hygiene lessens the impact of
xerostomia. Treatment for xerostomia focuses on
relief of symptoms and prevention of oral
complications, and includes:170,172
* Routine visits to dental professionals
* Twice daily brushing (teeth and tongue),
flossing, and rinsing; use high-fluoride
toothpaste to help prevent caries, and a
soft-bristled toothbrush (manual or electric) to
avoid damaging enamel, gingiva, and other
mouth tissues
* Use of over-the-counter oral lubricants
* Review medications that may contribute to
xerostomia (baclofen, oxybutynin) with the
physician or nurse to consider dose reductions
or other modifications
* Consider medications that stimulate salivary
glands (eg, locarpine, cevimeline);
* Avoid alcohol and alcohol-containing mouth
rinses (including toothettes)
* Avoid smoking (tobacco or cannabis), chewing
tobacco, and vaping
* Increase hydration (but avoid alcohol, caffeine,
and sugary drinks)
* Use sugar-free gum or hard candy to moisten
the mouth; avoid use of menthol lozenges
(menthol can be dehydrating)
* Avoid highly spicy foods, foods with high sugar
content, and fruits and vegetables with high
acid content173
* Monitor sodium intake
* Manage gastroesophageal reflux

Speech, Swallowing Issues, and Oral Health

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Multiple Sclerosis - A Practical Guide to Rehabilitation

Table of Contents for the Digital Edition of Multiple Sclerosis - A Practical Guide to Rehabilitation

Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 1
Multiple Sclerosis - A Practical Guide to Rehabilitation - 2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 3
Multiple Sclerosis - A Practical Guide to Rehabilitation - 4
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Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover3
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover4
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