Oral State and Salivary Cortisol in Multiple Sclerosis Patients

Background: MS patients experience gradual and progressive functional limitation, bulbar symptoms, cognitive dysfunction, and psychiatric disorders that can impinge on oral status. This study aimed to investigate the oral state, oral hygiene habits, and salivary cortisol levels in patients with relapsing-remitting multiple sclerosis (RRMS) compared to healthy controls. It also evaluated systemic parameters: disease duration, type of Disease Modifying Therapy (DMT), disability score, professional activity, and smoking in the study group. Methods: This study included 101 patients (71 women and 30 men, aged 16-71 years) and 51 healthy volunteers (36 women and 15 men, aged 28-82 years). The oral examination assessed the number of teeth, type and number of dental fillings and prosthetic restoration, oral hygiene state, and salivary cortisol. Results: It was found that MS patients had significantly more professional activity, swallowing problems, pronunciation issues, dry mouth, and taste disturbances than the control group. They brushed their teeth twice daily significantly less often. The API was higher, while the SBI was lower in MS patients. Disease duration positively correlated with age and number of missing teeth. The Expanded Disability Status Scale positively correlated with age, disease duration, number of missing teeth, number of composite fillings, and right and left-hand Nine Hole Peg test scores, and negatively correlated with the Sulcus Bleeding Index. Salivary cortisol levels did not differ between groups and correlated only with the disability scale. Conclusions: MS patients require ongoing dental care and preventive measures to manage both general and oral health symptoms effectively.