title: Managing the oral side-effects of medications used to treat multiple sclerosis.
abstract: BACKGROUND
  Many medications used to manage multiple sclerosis (MS) affect oral health. This review aimed to identify the oral side-effects of the current drugs recommended in Australia to treat MS and make dental practitioners aware of the range of symptoms.
  
  
  METHODS
  The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat MS. For each medication, the generic name, class, route of administration, dosage and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (MIMs) database. Meyler's Side-effect of Drugs Encyclopaedia was used to identify any additional oral adverse reactions to medications used to treat MS.
  
  
  RESULTS
  Fourteen drugs were identified for the treatment of MS progression and 13 drugs for the treatment of MS symptoms. For these medications, 18 oral side-effects were documented: xerostomia was the most common, followed by dysgeusia, dysphagia, mouth ulceration and sinusitis. Anticholinergic drugs caused xerostomia while immunosuppressants resulted in more infection-related side-effects.
  
  
  CONCLUSIONS
  Dental practitioners should be aware of the range of symptoms likely to be reported by this population. Clinicians are encouraged to continue providing dental care for their patients who develop MS and refer complex cases to specialists.
authors.affiliation: The University of Queensland, School of Dentistry, UQ Oral Health Centre, Brisbane, Queensland, Australia.
authors.forename: N
authors.identifier: http://orcid.org/0000-0003-0758-1605
authors.initials: N
authors.lastname: Cockburn
authors.affiliation: The University of Queensland, School of Dentistry, UQ Oral Health Centre, Brisbane, Queensland, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Pateman
authors.affiliation: The University of Queensland, School of Pharmacy, Pharmacy Australia Centre of Excellence, Brisbane, Queensland, Australia.
authors.forename: M W
authors.initials: MW
authors.lastname: Taing
authors.affiliation: The University of Queensland, School of Dentistry, UQ Oral Health Centre, Brisbane, Queensland, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Pradhan
authors.affiliation: The University of Queensland, School of Dentistry, UQ Oral Health Centre, Brisbane, Queensland, Australia.
authors.forename: P J
authors.initials: PJ
authors.lastname: Ford
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001315:Australia; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*; D019226:Oral Ulcer / Q000139:chemically induced / Q000628:therapy*; D012852:Sinusitis / Q000139:chemically induced / Q000628:therapy*; D013651:Taste Disorders / Q000139:chemically induced / Q000628:therapy*; D014987:Xerostomia / Q000139:chemically induced / Q000628:therapy*
chemical_list: D007166:Immunosuppressive Agents
keywords: Drugs; management; medication; multiple sclerosis; oral side-effects