Dental Issues Prevalent in EDS and HSD

We all want to have a smile as dazzling as our diagnoses (bah-duh-dum), but there are a number of dental issues that are common to people with Hypermobility Spectrum Disorders (HSD) and the Ehlers-Danlos Syndromes (EDS) that could make a great smile a short-lived treasure. Problems with collagen spell trouble for our teeth and their home, the jaw. Today we’ll cover the most common problems.

Periodontal Disease (gum disease, gingivitis and periodontitis) is an early onset condition for people with Ehlers-Danlos Syndome and Hypermobility Spectrum Disorders. Learn what you can do to prevent and manage gum disease, along with information on other common dental problems in this series on EDS and Dental Care.

Future posts will cover going beyond the basic dental care guidelines for bendy zebras and some recommendations for improving gum health from massage to specialized toothpastes and rarely known dental tools so you can keep your teeth looking a little better than Gladys’:

“Oh, Gladys. Just look at this mouth!”

Don’t have EDS or HSD? Take a look at our post Dental Care and Chronic Illness for a wide range of tips for other conditions.

Oral and mandibular issues are commonly reported by EDS patients of all types. Collagen defects can compromise oral health including, bone, teeth, gum tissue, nerve tissue, tendons and ligaments that help to hold our teeth in place, as well as our jaw. Poor dental outcomes can affect pain levels, functionality, nutrition and over all quality of life.

Bone Structure and Dentition

Tooth mobility is a common issue for many people with EDS and HSD and is thought to be related to the periodontal ligament, which has the sole job of holding each tooth in place. Several tooth abnormalities have been noted among EDS zebras. Posterior teeth are reported to have high cusps and deep fissures, making them difficult to clean and care for. The roots may also be shaped abnormally, elongated or fused. Pulp stones ( discrete calcifications that form within the pulp chamber) are seen in some. Congenital absence of teeth and microdontia (in which one or more teeth appear smaller than normal) have also been described in people with EDS.

Soft Tissue Abnormalities

The soft tissues of the mouth are particularly delicate and the oral mucosa can be particularly fragile. Mouth sores may be frequent for some with hypermobility. It is common for these tissues to be damaged with dental tools. We are also prone to early onset gum disease, which affects both soft tissues and eventually bone.

Early Onset Gum Disease

Since collagen is a component of teeth and gums, they can show the same weaknesses as any other collagen containing substance in our bodies. This is further complicated by the ligaments that hold our teeth in place, known as the periodontal ligament. Because of our collagen deficiency, ligaments can begin to stretch and fail over time, causing our teeth to become hypermobile, trapping more food in the gum line, creating the bacteria that leads to inflammation, gum loss and tooth decay.

If these issues aren’t enough to cause the beginnings of gum disease, it is believed that the structural defects in collagen or collagen-related proteins which are part of the immune system can increase susceptibility to degradation by bacterial pathogens. Given that the mouth is the perfect environment for bacteria, we’re often fighting a losing battle from the start.

People with hypermobility also tend to have poor blood flow and gums can easily become oxygen and nutrient deprived, adding to issues with the health of these tissues. I believe this also plays a role in numbing issues found in EDS, so I’ll discuss it in more detail when I talk more about gum massage and other therapies I’ve had success with, but it’s important to note that it can contribute to poor gum health.

Gum disease develops slowly over time and it’s common for EDSers to get early onset periodontal disease, which usually begins with gingivitis. Gingivitis is inflammation of the gums (gingiva) signaling early gum disease and is caused by a build up of plaque along the gum line, trapping bacteria and creating the perfect breeding grounds for infection.

Gingivitis is often a precursor for periodontal disease. In periodontitis, infection advances in the gums and spreads through the periodontal ligament and alveolar bone (the bony ridge containing tooth sockets), eating away at these structures and causing receding gums, bone loss, and even greater hypermobility of the teeth.

Temporomandibular Joint Dysfunction

Credit: Wikipedia Commons

The temporomandibular joint is very complex. It is best described as a sliding ball and socket joint worked by a series of muscles for chewing and talking. Because this complex network can affect the surrounding tissues, it’s important that the whole head and neck be examined and treated for TMD. In several studies, TMJ hypermobility and TMD have been linked to systemic joint hypermobility.

TMJ dislocation is noted to occur more often in women in the general population which mirrors that of EDS. The TMJ can relocate once hyperextended but cause the cartilaginous disc to stay dislocated resulting in pain, bony destruction, and limited mobility. The muscles of mastication can be overused, spasm, and cause referred face, head, and neck pain thus resulting in decrease functionality and quality of life.

In a recent study of 114 EDS patients comprising several types with an equal number of controls, a higher proportion of the EDS patients experi-enced hypermobile joints during extreme mouth opening, poor mouth opening ability when biting into thick food, clicking, crepitation, and permanent locking of the jaw open and closed. Many of the EDS patents reported decreased hypermobility of the joint with age.

Mitakides and Tinkle

Though these problems sometimes feel as insurmountable as Mt. Everest, there are things we can do to improve and even prevent these problems before they get started. In our next post, we’ll talk about several tactics that may help with these issues, including products I’ve found to help me keep my wins bigger than my losses in the fight against gum disease and TMD.

All joking aside, periodontal disease (gum disease, gingivitis and periodontitis) is an early onset condition for people with Ehlers-Danlos Syndome and Hypermobility Spectrum Disorders. Learn what you can do to prevent and manage gum disease, along with information on other common dental problems in this series on EDS and Dental Care.

There’s still a lot to cover regarding proper dental care and the prevention of common problems for people with hypermobility. My next post on oral care will cover what our basic dental care should cover and some great tools, special toothpastes and rinses. Then we’ll move onto issues of numbness and of course, TMD. I hope you join us!

In the meantime, what kind of dental problems are you experiencing? What are some of the best tools you’ve found that help? Let us know in the comments and I might include it in one of our future posts!

Resources and Further Reading

9 thoughts on “Dental Issues Prevalent in EDS and HSD

  1. I highly recommend doing all you can manage to make appt with Dr John Mitakides. He taught me more about how to relieve my TMJ related pain issues I’d suffered from for many yrs. I can now instantly rid my pain (neck, headache, shoulder and back areas) with the technique he teaches. He is expensive, does not take insurance, but has been the best help I’ve had so far in my short 8 mo journey concerning this particular issue. Well worth his weight in gold.

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  2. This post is SO helpful! I have some gum problems and was actually somewhat relieved when I learned they were common with hypermobility. I brush and floss regularly and was kind of surprised when my dentist said I have problems with my gums. I also have TMJ.
    I actually have a dentist appointment this week to get a new mouthguard – in addition to the above, I also badly grind my teeth.
    As if we didn’t have enough, non-mouth related problems, right?

    Liked by 1 person

    1. I’m sorry this is also such a trial for you, Lindsay! It’s been a lifelong battle. I even knew there was something affecting the women in my family and not a single woman before me kept her teeth a year past childbirth. My mother lost hers at 17 and I got crazy about my dental care when it happened to my oldest sister at the same age (they were both teen moms) . I knew all this and worked so hard at my dental care and was still told by the time I was 30 that I had the gums of a 50 year old smoker. I’m fighting hard and still have most of my teeth, except most of my molars. The last bit of dental hell I went through cost me two teeth and TMD. Oh yes, and the grinding of teeth, I feel you there, too. I used to do it sometimes even awake. I think it’s the anxiety and tension from the dysautonomia. It’s hell on our enamel and sensitivity. Do the gums around your teeth ever just ache? Mine do sometimes in bad weather or when flaring, just like my arthritic joints and sometimes for no reason at all. Thanks for sharing your thoughts with me. You helped me realize that list of issues probably needs to be even longer. I hope the posts that come out after this help give you some ideas that will help and good luck with the mouth guard. I really hope it helps!

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  3. I think its also important to have a good dentists that recognises EDS too, I have lost about 6 teeth under an old dentists I changed and the new dentists realised it was due to my EDS so now sees me every 3 months rather than 6 months.. My dentists smiles like jaws quite literally lol

    Liked by 1 person

  4. “…keep your teeth looking a little better than Gladys’” 😂 Talking about teeth really does put my teeth on edge! I’m not happy with mine and I do have problems, including with my gums, which is a bit worrying. I also have to have more regular X-rays because of osteopenia.

    You’ve covered a range of issues really well, and I’m glad you’ve gone beyond the basics to look at things like soft tissue and bone structure and TMJ. Very nicely done!

    And this reminds me, I’m pretty sure I’m due a check-up soon. I have a feeling it coincides with my car MOT in November, so it’s going to be an expensive month! Nooooooo… hate the dentist!
    Caz xx

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    1. Sorry, Caz! It is definitely a sore subject for many of us. The cost is no joke, either! Why is everything that’s ‘good’ for us so doggone expensive? After the trials I’ve been dealing with, I really hope doing this series might save someone a few of the same difficulties and some pain at the dentist’s office. I’m glad my joking zebras helped lighten the mood on an otherwise rotten subject! xx

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