Dental considerations for a patient with Myalgic Encephalopathy/ Chronic Fatigue Syndrome – a case study, by Serena Halsall in Journal of Disability and Oral Health Vol 20, #3  October 1, 2019

Abstract

Myalgic Encephalopathy, also known as Chronic Fatigue Syndrome (ME/CFS), is a chronic condition with: a range of fluctuating symptoms, no cure, and can cause a person to be bedbound. This case report identifies recommendations for dental care based on the experiences of a female 17-year-old living with severe ME/CFS.

Excerpt

Around the age of 16, Patient X’s functional ability improved, thus allowing her to tolerate the travel to her GDP with her carer and have a dental examination.

Reasonable adjustments were made with:

• The appointment being booked at a time that corresponded with Patient X’s energy levels
• A ramp to allow wheelchair accessibility into the practice and the surgery being on the ground floor
• The patient wearing sunglasses and noise cancelling headphones to reduce visual and auditory stimulation
• The dentist offering to carry out the examination with the patient in her wheelchair or on the dental chair
• Oral hygiene instructions being given to the patient and their carer.

Conclusions

ME/CFS can have severe and unpredictable effects on a person’s life. With a prevalence of 1 in 250 people, it is important that the dental team understands its nature and potential severity, which can present a barrier to accessing dental care. For these high priority patients, it is essential that their dental health is not overlooked. To conclude, the
following recommendations are made:

• The dental team must have a good understanding of ME/CFS, its symptoms and effects on access to healthcare, to support the patient and their carer(s) and to optimise oral health
• The dental team should consider the variable and fluctuating symptoms of ME/CFS and should make the patient aware of the available support if symptoms of the condition worsen
• After a discussion with the patient and their carer(s), the dental team should be able to identify the patient’s specific individual needs and make the necessary adjustments to improve their dental care
• The dental team should recognise if a patient is unable to attend dental appointments and should act to facilitate their access to dental care, by liaising with other healthcare disciplines to provide special care dentistry
• A multidisciplinary approach should be considered, to provide the most appropriate and accessible dental care, working with the patient’s wider healthcare team and other dental disciplines.