Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke

Mituuti, Cláudia Tiemi; Bianco, Vinicius Cappo; Bentim, Claudia; Andrade, Eduardo Carvalho de; Rubo, José Henrique; Berretin-Felix, Giédre

doi:10.2147/cia.s62314

Cited by 20 publications

(21 citation statements)

References 25 publications

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“…These results confirm our previous findings, indicating that community-dwelling individuals with loss of teeth occlusion, without replacement by dental prosthesis, were more likely to have a higher risk of dysphagia (7). The present findings also support the results of previous studies, which have reported that individuals without functional occluded pairs of natural teeth were more likely to have a higher risk of dysphagia (14)(15)(16)(17). A previous study including bedridden older people with dysphagia reported that jaw stabilisation by occluding the posterior natural teeth or through placement of dental prosthetics was important for smooth swallowing (17).…”

Section: Discussionsupporting

confidence: 92%

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study

Okabe

Takeuchi

Izumi

et al. 2017

J of Oral Rehabilitation

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The total number of natural teeth was related to swallowing function among older adults; however, limited information is available regarding the impact of occluding pairs of teeth on swallowing function. This study aimed to examine the association between posterior teeth occlusion and dysphagia risk in older nursing home residents. This cross-sectional study included 238 residents aged ≥60 years from eight nursing homes in Aso City, Japan. Swallowing function was evaluated using the modified water swallowing test (MWST); the primary outcome was dysphagia risk (MWST score ≤3). Posterior teeth occlusion was assessed using number of functional tooth units (FTUs), determined based on number and location of the remaining natural and artificial teeth on implant-supported, fixed or removable prostheses. Univariate and multivariate logistic regression analyses were performed to examine the association between posterior teeth occlusion and dysphagia risk, adjusted for the covariates of number of natural teeth, demographic characteristics, comorbidities, physical function, body mass index and cognitive function. Of the 238 subjects, 44 (18·5%) were determined to be at risk of dysphagia based on the MWST scores. The odds ratio (OR) of dysphagia risk decreased in subjects with higher total FTUs [OR = 0·92, 95% confidence interval (CI) 0·87-0·98]. After adjusting for covariates, this association remained significant (OR = 0·90, 95% CI 0·84-0·97). Loss of posterior teeth occlusion was independently associated with dysphagia risk in older nursing home residents. Maintaining and restoring posterior teeth occlusion may be an effective measure to prevent dysphagia.

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Section: Discussionsupporting

confidence: 92%

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study

Okabe

Takeuchi

Izumi

et al. 2017

J of Oral Rehabilitation

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“…Even though there is no reliable evidence that the treatment of periodontitis can reduce the chances of suffering from a stroke, due to the difficulties to collect and design a reliable study,57 the control of infectious diseases may represent a decrease in other risk factors also related to stroke 50. Moreover, the control of oral health in post-stroke patients has shown benefits related to oropharyngeal dysphagia and oral intake level 58…”

Section: Discussionmentioning

confidence: 99%

<p>Periodontitis As A Risk Factor For Stroke: A Systematic Review And Meta-Analysis</p>

Fagundes¹,

Almeida²,

Vilhena³

et al. 2019

VHRM

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This systematic review and meta-analysis investigate the association between periodontitis and stroke. This review followed the methods established by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searches were conducted in five databases and two sources of grey literature. After the selection of the articles, a risk of bias evaluation was performed. Three meta-analyzes were performed: Assessing the overall association between stroke and periodontitis in case–control studies; Ischemic stroke and periodontitis in case–control studies; The association between stroke and periodontitis in cohort studies. Heterogeneity was assessed using the I2 index and the odds ratio was also calculated (p < 0.05). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to evaluate the level of evidence. 2193 potentially relevant studies were identified, with 10 studies included in qualitative and quantitative analysis. All the articles were considered with low risk of bias and a low level of certainty. The results demonstrated a positive association between both disorders and increased risk for stroke among cohort studies (RR 1.88 [1.55, 2.29], p<0.00001, I2=0%) and for ischemic stroke events in case–control studies (RR 2.72 [2.00, 3.71], p<0.00001, I2= 4%). Periodontitis may represent a risk factor for stroke, especially in ischemic events. However, new studies with a robust design are necessary for a reliable conclusion.

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“…Oral intake levels in patients with chronic stroke are associated with the need for a new prosthesis, the type of prosthesis and the number of residual teeth 13 . However, the association between oral intake levels and the oral status/oral functions of inpatients admitted to acute care hospitals has not previously been elucidated.…”

Section: Introductionmentioning

confidence: 99%

Food intake and oral health status of inpatients with dysphagia in acute care settings

Furuya

Suzuki

Tamada

et al. 2020

J of Oral Rehabilitation

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Oral feeding and swallowing functions tend to decline with age, and functional problems are exacerbated in older subjects with systemic disorders, including cerebrovascular disorders. 1 The reported prevalence of dysfunction involving oral feeding and swallowing is approximately 30% in community-dwelling elderly subjects 2 and 50% in institutionalised individuals. 3 Many patients admitted to acute care hospitals are affected by dysphagia due to the impact of various systemic disorders.Matsuo et al 4 reported that dysphagia affects more than 25% of inpatients in acute care hospitals. Dysphagia causes aspiration pneumonia, 5 malnutrition, dehydration 6,7 and dietary restrictions. Moreover, AbstractAdequate oral status and functional assessments are important for dysphagia rehabilitation in acute care inpatient settings, especially to establish individualised oral intake. However, the association between food intake levels and oral function has not been elucidated in acute care inpatients. This cross-sectional study clarified the association between oral intake levels and the oral status/function of patients with dysphagia admitted to acute care settings. Admitted patients aged ≥40 years (n = 459; men: 288; mean age: 70.8 ± 12.0) examined at the Department of Dysphagia Rehabilitation at the Iwate Medical University Hospital from April 2007 to March 2014 were included. The oral health status was evaluated by the tongue coating, oral dryness severity, plaque control, posterior occlusal support and a repetitive saliva swallowing test (RSST). Dysphagia severity was determined from the Dysphagia Severity Scale. Oral intake levels were evaluated using the Functional Oral Intake Scale (FOIS) at the time of the initial dental examination (FOIS-I), and they were reevaluated after the revision of levels according to the participants' general condition and oral health status (FOIS-R). Divergence between FOIS-I and FOIS-R was noted in >40% patients. Multiple regression analysis showed significant associations between FOIS-R and consciousness level, activities of daily living, tongue coating, RSST and posterior occlusal support. Patients with dysphagia in acute care settings require detailed assessments of their oral status and function, including swallowing, to determine the most suitable feeding methods and dental interventions to improve oral intake levels. K E Y W O R D S acute care, dentures, dysphagia, oral health, posterior occlusal support, swallowing | 737 FURUYA et Al.since eating is an enjoyable day-to-day experience, dysphagia causes deterioration in the quality of life (QOL). 8Early rehabilitation is effective in dysphagia management. Hence, even in acute care settings, proper dysphagia rehabilitation must be started at an early stage after stabilisation of the patient's general condition. 9 Improvement of the oral status and function is important to conduct dysphagia rehabilitation safely. 10 However, inpatients with dysphagia, particularly elderly patients, have poor oral health and hygiene with a high prevalence ...

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Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke

Cited by 20 publications

References 25 publications

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study

<p>Periodontitis As A Risk Factor For Stroke: A Systematic Review And Meta-Analysis</p>

Food intake and oral health status of inpatients with dysphagia in acute care settings

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