Oral Manifestations of Multiple Sclerosis: A Systematic Review
Bibliographic record
Abstract
Background: 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. Aim: 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. Results: 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 (p < 0.05), and between periodontal health and degree of disability (p < 0.05). However, heterogeneity in methodology and lack of longitudinal studies were noted as limitations. Conclusions: 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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.008 |
| Bibliometrics | 0.013 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".