Dentistry considerations for the dysphagic patient: Recognition of condition and management

Abstract

Dysphagia is a symptom of various underlying medical conditions. It can be attributed to age related changes, neurological, cognitive, respiratory and gastrointestinal diseases. These conditions may cause functional and anatomical changes along the swallowing tract. Impaired swallowing function and oromotor insufficiencies may result in inadvertent aspiration of fluids and/or particles during dental procedures. This article attempts to highlight the importance of identifying patients with dysphagia and discusses ways to reduce life threatening conditions that may arise during dental procedures.

Questões fonoaudiológicas e odontológicas na percepção de idosos que acessam serviços do Sistema Único de Saúde

“…Este é um resultado relevante, pois sinaliza a necessidade e a importância do profissional da odontologia ter um olhar mais ampliado e acurado em relação à manutenção da saúde bucal do idoso de modo que, na busca pela prevenção em um acompanhamento regular, o dentista possa indagar questões como a qualidade da mastigação, da deglutição e da alimentação deste idoso e com isso, encaminhá-lo para os cuidados de um fonoaudiólogo(a). Questões fonoaudiológicas e odontológicas são fundamentais para prevenção de alterações na deglutição 20,21 . O cuidado interdisciplinar, o trabalho em equipe, e o compartilhamento do saber são essenciais para o diagnóstico e construção de um cuidado integral à saúde de um idoso com disfagia 22,23 .…”

Complications and treatment errors in periodontal therapy in medically compromised patients

“…There are multiple causes of dysphagia, including cerebral palsy, learning disability, stroke, and previous head and neck cancer therapy. [153][154][155] Periodontitis represents a potential risk factor for the development of aspiration pneumonia in the elderly. 156 Dental plaque has been suggested as a risk factor for healthcare-associated pneumonia in patients who are hospitalized, with an increase in dental plaque levels with longer hospital stays.…”

“…154 It is important to note that some patients will be at risk of silent aspiration during procedures, without any signs or symptoms of protective reflexes. 155…”

“…Patients with dysphagia are at risk of aspiration, which may progress to pneumonia, which carries a significant risk of morbidity and mortality. There are multiple causes of dysphagia, including cerebral palsy, learning disability, stroke, and previous head and neck cancer therapy 153‐155 …”

“…When delivering periodontal care, there are several strategies that can be implemented to reduce the risk of aspiration. Depending on the severity of dysphagia, patients may need to be kept in an upright or semisupine position of no more than 45° if the airway is compromised 154,155,159,160 . The airway may be protected with a gauze trap 155 .…”