Oral Opportunistic Bacteria in Multiple Sclerosis with Different Treatment Modalities

Aims: Multiple sclerosis is a chronic demyelinating disease that is considered an autoimmune disorder affecting the central nervous system. This study aimed to investigate the pathogenic changes in the natural flora of the mouth in MS patient during different treatment modalities and compare them with healthy individuals. Materials Methods: 120 patients were volunteered and divided into four groups of 30 people: 1) patients with MS taking Natalizumab or Tysabri, 2) patients with MS taking Betaferon, 3) naive MS patients without medications, 4) healthy individuals (control). The changes in oral bacteria (Staphylococcus aureus, Porphyromonas gingivalis, and Bacteroides fragilis) were investigate using real time-PCR. Findings: The prevalence of S. aureus was significantly higher in the Naive MS group (p=0.016), Betaferon group (p=0.001), and Tysabri group (p=0.0001) compared to the healthy group, as well as in Tysabri group compared to the Naive MS group (p=0.005). The prevalence of P. gingivalis was significantly higher in the Betaferon group (p=0.002) and Tysabri group (p=0.0001) compared to the healthy group, as well as in Tysabri group compared to the Naive MS group (p=0.020). The prevalence of B. fragilis was significantly higher in the Naive MS group (p=0.008), Betaferon group (p=0.015), and Tysabri group (p=0.008) compared to the healthy group. Conclusion: Oral bacteria are involved in MS development. Furthermore, MS patients are more susceptible to periodontal disease due to high P. gingivalis presence, and these patients need to receive extra care to prevent periodontal disease.