Dentistry and Myasthenia If your myasthenia is under good control, there is no reason why you can't have normal dental care. Good communication between yourself and your dentist is vital. You must know exactly what the dentist is going to do. The dentist needs to know your limitations, and to be prepared for them. This should help you to relax and co-operate more fully. It is vital that the dentist consults with the neurologist at the planning stage if surgery is necessary and it may also help even for normal care. It helps to book appointments for the morning or whenever strength is greatest and to keep them short. If there are difficulties in opening and closing the mouth, in holding the head up, or in swallowing, the dentist needs to know so as to prevent problems. A mouth prop may help to keep the mouth open. Thorough suction (controlled by the patients themselves) helps to avoid drooling or choking problems. Even root canal work need not be traumatic. A rubber dam may be needed to prevent worries about choking. If you tend to regurgitate fluids into your nose, you may prefer to sit more upright in the dental chair. Local anaesthetics are preferable to general for people with myasthenia Prevention is vital to avoid dental emergencies. They are most stressful and can aggravate myasthenia. Excellent home care habits are crucial, however difficult they may be. They include regular brushing, daily flossing, cleaning between teeth, and oral cleanliness. Regular dental visits and cleaning are also important to keep the teeth free of plaque. The gums are liable to infections and the patient may not even be aware of them. If severe, they can have knock-on effects on myasthenia and/or lower resistance. Proper care is vital.