The Struggle with a Dental Visit

Myasthenia gravis (MG) is an autoimmune disorder that creates challenges for our medical and dental care. You may not be accustomed to having to research every aspect of your care, but as those with MG know, it's something we do.¹

There are many medications that can interact either with our treatment for myasthenia or for the disorder itself. In addition, oral hygiene and care can also provide more challenges.¹

Communicate with your doctors

When visiting your dental practitioner, you should be sure all staff involved in your treatment are aware of your special needs. Before having work done on your teeth, talk with your neurologist first. See if there are special steps you need to take prior to your dental visit.

My neurologist wanted me off my CellCept prior to having any teeth pulled. Depending on the treatment you will be receiving, your doctor may want you on antibiotics prior to your visit. You also might want to discuss whether you should increase your steroid dose before stressful or complicated dental procedures or before undergoing general anesthesia.

For me, it’s never a good idea to schedule an appointment when my secretions are high. During any procedure, my dental staff should be vigilant about protecting my throat from water and debris.

Make sure the office is prepared

Ask your neurologist what medications may interact with your treatment or MG. Take that information with you to your dental appointment and share it with your caregivers. They should also know what to watch for should there be complications. Ask about their training and equipment used in resuscitation.

They should have resuscitation equipment in the office and a staff that knows what to do. They also should know medication to counteract the drugs they give you. If a respiratory collapse does occur, the dental staff should be trained and able to perform basic CPR until the ambulance arrives.

Dentists do have suction devices for the dental procedure and those can be used to suction secretions in an emergency situation.¹

Treatment modifications

Your dental treatment may need to be altered to accommodate your altered muscle strength. Be sure to identify any MG weakness or crisis, as you know, MG thrives on stress. Schedule shorter appointments. You may not be able to tolerate longer appointments, so talk with your dentist and try to spread the work out as needed.

Some MG medications, such as Mestinon, are quick acting, which means they start working within about 1 an hour after taking them. Check with your neurologist to see if you need to schedule early for that reason.

If you are one of those patients that suffers from frequent or significant exacerbations of the throat, respiratory tracts, or generalized weakness, it may be best to treat you in a hospital setting or a facility with all the appropriate emergency equipment and qualified staff.

Though I stated to make sure your dentist has these emergency equipment and supplies in their office, hospitals are generally a safer alternative for those of us with serious exacerbations.