García-Rios Paula, Rodríguez-Lozano Francisco Javier, Pecci-Lloret Miguel Ramón
Gerodontologý and Special Care Dentistry Unit, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, IMIB-Arrixaca, 30008 Murcia, Spain.
J Clin Med. 2025 Apr 24;14(9):2944. doi: 10.3390/jcm14092944.
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by diverse clinical manifestations, including the potential involvement of the oral cavity. Oral symptoms in MS patients may arise both as direct consequences of the disease and as side effects of pharmacological treatments. These manifestations, such as xerostomia, periodontal disease, and dental sensitivity, can significantly affect quality of life and may be underrecognized in clinical practice. To systematically assess the presence and relevance of oral manifestations in patients with MS, and to identify correlations between these symptoms and clinical parameters such as MS phenotype, disease duration, and disability level. Materials and Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A database search was conducted in PubMed and Scopus on 17 March 2025, using terms related to "multiple sclerosis" and "oral manifestations". Inclusion criteria were limited to observational studies published in the last ten years, focusing on oral symptoms in MS patients. Furthermore, the quality of the studies was assessed following the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies, and the JBI Critical Appraisal checklist for analytical cross-sectional studies. Ten studies met the inclusion criteria. The most frequently reported oral manifestations were hyposalivation, gingival inflammation, increased DMFT and plaque indices, dental sensitivity, and oral pain. Several studies found statistically significant associations between oral dryness and MS phenotype ( < 0.05), and between periodontal health and degree of disability ( < 0.05). However, heterogeneity in methodology and lack of longitudinal studies were noted as limitations. This review highlights a clear relationship between MS and several oral health disturbances, particularly xerostomia and periodontal disease. The findings underscore the need for multidisciplinary care approaches and further studies with standardized protocols to better understand oral-systemic interactions in MS.
多发性硬化症（MS）是一种中枢神经系统的慢性自身免疫性疾病，其临床表现多样，包括口腔可能受累。MS患者的口腔症状既可能是疾病的直接后果，也可能是药物治疗的副作用。这些表现，如口干、牙周病和牙齿敏感，会显著影响生活质量，且在临床实践中可能未得到充分认识。为了系统评估MS患者口腔表现的存在情况及相关性，并确定这些症状与MS表型、疾病持续时间和残疾程度等临床参数之间的相关性。材料与方法：按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价。于2025年3月17日在PubMed和Scopus数据库中进行检索，使用与“多发性硬化症”和“口腔表现”相关的术语。纳入标准仅限于过去十年发表的观察性研究，重点关注MS患者的口腔症状。此外，根据队列研究和病例对照研究的纽卡斯尔-渥太华量表（NOS）以及分析性横断面研究的JBI批判性评价清单对研究质量进行评估。十项研究符合纳入标准。最常报告的口腔表现为唾液分泌减少、牙龈炎症、DMFT和菌斑指数增加、牙齿敏感和口腔疼痛。几项研究发现口腔干燥与MS表型之间存在统计学显著关联（<0.05），牙周健康与残疾程度之间也存在统计学显著关联（<0.05）。然而，研究方法的异质性和缺乏纵向研究被指出是局限性。本综述强调了MS与几种口腔健康问题之间的明确关系，特别是口干和牙周病。研究结果强调了采取多学科护理方法以及开展采用标准化方案的进一步研究以更好理解MS中口腔-全身相互作用的必要性。
