Dental Healthcare and Muscular Dystrophy

Muscular dystrophy is a group of degenerative diseases that cause weakness and the loss of muscle mass. It occurs mainly in boys, and can appear as early as age three. Patients who are not treated are usually unable to walk by the time they’re about ten. While advances in medicine have extended the lifespans of some patients, muscular dystrophy is often fatal by the late teens because of respiratory or heart problems.[1]

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The term muscular dystrophy (MD) refers to more than thirty conditions, the most common of which is Duchenne muscular dystrophy (DMD). It isn’t known how common other forms are, in part because symptoms can vary so much from one patient to the next. This article mainly describes Duchenne MD, but also considers Becker (BMD). BMD is similar to DMD, but the symptoms are not as severe, and it progresses more slowly.[2]

Muscular dystrophy brings on a host of life challenges, including proper dental care. The Center for Dental Anesthesia in Alexandria is equipped to treat patients with MD and other special needs.

A Cruel Disease

Muscular dystrophy is a particularly cruel disease. Children who are diagnosed with it gradually lose their ability to walk, move their arms and hands, and even to breathe easily. In about a third of all cases, there is no family history of the disease. While medication and physical therapy can slow its progress there is currently no cure, nor can it be prevented or reversed.[3]

Suzan Norton’s son Mike was diagnosed with DMD when he was four years old, and the news devastated her. “I spent the next six months in chronic sorrow,” she recalls. “But one day I woke up and knew we could be OK.” She and her family got involved with the Muscular Dystrophy Association and learned to have hope. “MDA and all its resources are there to help.”[4]

In 1986, research supported by MDA identified a gene on the X chromosome that, if it mutates, leads to DMD. Women are DMD carriers, but carriers don’t usually have any signs or symptoms.[5]

MD and Dentistry

MD patients and their loved ones face challenges every single day, and the disease remains a grim subject. “I can fight with it,” one MD patient said bluntly, “but I can’t beat it.”[6]

The effects of MD do not spare the muscles of the face and mouth. Consequently, it can have a major impact on dental health, leading to these common issues:

Chewing difficulties
Swallowing difficulties
High rates of malocclusion (improper bite alignment)[7]

People with DMD are also more likely to have poor dental hygiene. Even with help from caregivers, it may be difficult for the patient to open his jaw or move his tongue out of the way. It is common to find higher than ordinary rates of tooth decay, plaque buildup, poor gum health, and poor dentition.[8]

At home, most patients will eventually need help brushing and flossing their teeth. Whoever has this responsibility must understand that patience and skill are necessary so that their efforts are successful. In order to maintain the patient’s dental health, caregivers should make sure that:

Teeth are brushed daily
Teeth are flossed daily
The patient has regular dental checkups[9]

Many of the issues that make everyday life a challenge for MD patients are present in the dentist’s office. Since many are in a wheelchair by the age of ten, just getting into the office may be a challenge. The Center for Dental Anesthesia is fully wheelchair accessible, and many dental practices throughout the United States follow that example. Some patients, of course, are able to walk but may be more likely to fall. Dental professionals should take appropriate precautions.[10]

Never Give Up Hope

New and better treatments for DMD and other forms of muscular dystrophy are developed all the time, and Suzan Norton tells people like herself, whose loved ones have the disease, to remain optimistic. “Surround yourself with inspirational and positive people,” she advises. “Let your love for your child give you strength. Never give up your hopes and dreams.” Her son has graduated from high school and has many friends, including a girlfriend. “He’s taught me more than I’ve taught him.”[11]

Dr. Mady is always here to provide
honest and gentle dental care … and
would be happy to speak with you
soon and help you design a treatment
plan that’s right for you.

Caregivers and the loved ones of people with MD must be proactive in the management of their dental care. The combined effects of the progression of the disease and the weakening of the facial muscles means there must be constant vigilance.

No matter your age or physical condition, good dental health is important. It should never be viewed as some kind of bonus. At the Center for Dental Anesthesia in Alexandria, we believe that no one should be without quality dental care because of a physical limitation. Our entire facility is wheelchair accessible and provides specialized dental chairs and equipment. Each team member is very familiar with relevant protocols, and has years of experience in providing dental healthcare to patients with DMD and other special needs. Please call our office to schedule an appointment.

For anyone with a loved one facing the challenges of muscular dystrophy, you can read about the latest in medical management, and find other useful information, on the Muscular Dystrophy Association website.

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Notes

[1] Mayo Clinic website. Referred to hereafter as Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/muscular-dystrophy/symptoms-causes/syc-20375388.

Lifespans: “Patients living longer with Duchenne muscular dystrophy pose new challenge for caregivers,” Science Daily website. Referred to hereafter as “Lifespans.”

https://www.sciencedaily.com/releases/2018/03/180312133008.htm.

[2] “Muscular Dystrophy.”

https://kidshealth.org/en/parents/muscular-dystrophy.html.

More than thirty forms: “All About Muscular Dystrophy,” Referred to hereafter as All About.

https://www.medicalnewstoday.com/articles/187618.php.

[3] Mayo Clinic.

[4] “Facts About Duchenne & Becker Muscular Dystrophies.” referred to hereafter as Facts.

https://www.mda.org/sites/default/files/publications/Facts_DMD-BMD_P-211_0.pdf.

[5] “Duchenne Muscular Dystrophy (DMD).” Referred to hereafter as DMD.

https://www.mda.org/disease/duchenne-muscular-dystrophy.

[6] Quote: “21 Truths People With Muscular Dystrophy Wish Others Understood.”

https://themighty.com/2015/11/living-with-muscular-dystrophy-what-to-know/