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Blasi AM, Derman SHM, Kunnel A, Pape P, Röhrig G, Barbe AG. Oral Health and the Association with Blood Parameters in Neurogeriatric Inpatients without Relevant Systemic Inflammation: An Observational Study. Geriatrics (Basel) 2024; 9:55. [PMID: 38804312 PMCID: PMC11130911 DOI: 10.3390/geriatrics9030055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
As little evidence is available, we report the oral health of neurogeriatric inpatients and the association with hematological parameters representing systemic health. We performed a cross-sectional investigation of 30 patients undergoing neurogeriatric early rehabilitation and excluded systemic inflammation as a trigger for oral infection (C-reactive protein >5 mg/dL). Outcomes included oral health and hygiene status and routine laboratory parameters. Patients (mean age 79 ± 6 years, mean comorbidities 7 ± 3, and mean Barthel Index at hospital admission 31 ± 18) had impaired oral health (mean 18 ± 7 of their own teeth, elevated plaque indices (2.5 ± 0.4), and bleeding on probing (26 ± 17)), representing short- and long-term reduced oral hygiene. Twenty-four (80%) patients had periodontitis. Laboratory parameters for inflammation, nutrition, and anemia did not correlate with oral health parameters (p > 0.05). The number of teeth correlated moderately with total protein (Spearman's rank correlation coefficient (rs) = 0.524; p = 0.003). Plaque indices correlated weakly with number of teeth (rs = -0.460; p = 0.010) and periodontitis diagnosis (rs = 0.488; p = 0.006). Thus, highly vulnerable neurogeriatric inpatients had reduced oral health and hygiene independent of laboratory parameters, representing a high-risk population for oral health problems even without clinically proven systemic infection. This should be considered in future interprofessional therapy planning.
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Affiliation(s)
- Alicia Maria Blasi
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, D-50923 Cologne, Germany; (A.M.B.); (S.H.M.D.)
| | - Sonja Henny Maria Derman
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, D-50923 Cologne, Germany; (A.M.B.); (S.H.M.D.)
| | - Asha Kunnel
- Clinic for Early Neurological and Interdisciplinary Rehabilitation, St. Marien-Hospital, D-50668 Cologne, Germany; (A.K.); (P.P.)
| | - Pantea Pape
- Clinic for Early Neurological and Interdisciplinary Rehabilitation, St. Marien-Hospital, D-50668 Cologne, Germany; (A.K.); (P.P.)
| | - Gabriele Röhrig
- Department of Health, EUFH-European University of Applied Sciences, D-50996 Cologne, Germany;
| | - Anna Greta Barbe
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, D-50923 Cologne, Germany; (A.M.B.); (S.H.M.D.)
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Bashirian S, Khoshravesh S, Ayubi E, Karimi-Shahanjarini A, Shirahmadi S, Solaymani PF. The impact of health education interventions on oral health promotion among older people: a systematic review. BMC Geriatr 2023; 23:548. [PMID: 37697260 PMCID: PMC10494401 DOI: 10.1186/s12877-023-04259-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people. METHODS Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP). RESULTS In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality. CONCLUSION This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field.
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Affiliation(s)
- Saeid Bashirian
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Community Health Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Akram Karimi-Shahanjarini
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samane Shirahmadi
- Department of Community Oral Health, School of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Parshang Faghih Solaymani
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Abstract
Gastrointestinal (GI) complications are seen in over 50% of ischemic stroke survivors; the most common complications are dysphagia, constipation, and GI bleeding. The bidirectional relationship of the gut-brain axis and stroke has recently gained traction, wherein stroke contributes to gut dysbiosis (alterations in the normal host intestinal microbiome) and gut dysbiosis perpetuates poor functional neurologic outcomes in stroke. It is postulated that the propagation of proinflammatory cells and gut metabolites (including trimethylamine N-oxide and short-chain fatty acids) from the GI tract to the central nervous system play a central role in gut-brain axis dysfunction. In this review, we discuss the known GI complications in acute ischemic stroke, our current knowledge from experimental stroke models for gut-brain axis dysfunction in stroke, and emerging therapeutics that target the gut-brain axis.
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Affiliation(s)
- Heather Y F Yong
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Aravind Ganesh
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Carlos Camara-Lemarroy
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Canada
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Schimmel M, Anliker N, Sabatini GP, De Paula MS, Weber AR, Molinero-Mourelle P. Assessment and Improvement of Masticatory Performance in Frail Older People: A Narrative Review. J Clin Med 2023; 12:jcm12113760. [PMID: 37297955 DOI: 10.3390/jcm12113760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
According to the World Health Organization (WHO), the estimated number of older adults is around 962 million and is projected to increase to 2.1 billion by 2050. The oral frailty concept is associated with gradual oral function loss in relation to aging. There is a need to emphasize the improvement of oral function based on an evaluation of masticatory performance in patients with various oral conditions or systemic diseases and especially in the frail elderly. The present narrative review presents an overview of the current state of the assessment and improvement of masticatory performance in frail older people. To fully encompass oral frailty, oro-facial hypofunction, or oro-facial fitness, dental Patient Reported Outcomes (dPROs) should be included; nevertheless, there are limited evidence-based rehabilitation approaches. The concept of oral frailty, oro-facial hypofunction, or oro-facial fitness should involve dental Patient Reported Outcomes (dPROs), and in this sense, there are only a few evidence-based rehabilitation procedures to improve oro-facial hypofunction besides prosthodontics. It must be considered that reduced neuroplastic capacity in old individuals might preclude a positive outcome of these strategies that might need to be accompanied by functional training and nutritional counseling.
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Affiliation(s)
- Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Noemi Anliker
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Gabriela Panca Sabatini
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Prosthodontics, University of São Paulo (USP), São Paulo 05508-900, Brazil
| | - Marcella Silva De Paula
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Prevention and Oral Rehabilitation, Universidade Federal de Goiás, Goiania 74690-900, Brazil
| | - Adrian Roman Weber
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
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5
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Yakşi E, Horasan N. Vitamin D levels and oral health in stroke patients during inpatient rehabilitation. J Oral Rehabil 2023; 50:293-299. [PMID: 36648365 DOI: 10.1111/joor.13415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Stroke is a severe that restricts the individual's functions, effects the oral health. OBJECTIVES The aim of this study was to investigate the relationship between oral health and vitamin D levels in stroke patients in rehabilitation units. METHODS Participants with stroke, and age- and sex-matched healthy controls were recruited for the study. Oral Health Impact Scale-14 (OHIP-14), Decayed, Missing, Filled Teeth (DMFT) Index, Community Periodontal Index of Treatment Needs (CPITN), Gingival Index (GI) and Plaque Index (PI) were assessed for all participants. Barthel Index (BI), Brunnstrom Recovery Scale (BRS) and Modified Ashworth Scale (MAS) assessed for the stroke patients. Vitamin D levels of each participant were recorded. RESULTS The stroke patients' DMFT index and OHIP-14 values were higher than those of the healthy controls (p < .05). However, no significant differences were observed in terms of CPTIN, PI, or GI scores (p > .05). No statistically significant difference was determined in the DMFT index, OHIP-14 scores, Community Periodontal Index of Treatment Needs (CPITN), PI (Plaque Index) and GI (Gingival Index) scores according to vitamin D levels among the stroke patients (p > .05). Stroke patients' functional scores (BRS, MAS and BI), vitamin D levels and oral health status (OHIP-14, DMFT, CPITN, PI and GI) were subjected to correlation analysis. This revealed significant negative correlation between BRS (arm, hand and leg), and BI and OHIP-14 scores (p < .05). CONCLUSION Although the DMFT index and oral health-related quality of life were adversely affected in stroke patients, no relationship was found between vitamin D and oral health status.
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Affiliation(s)
- Elif Yakşi
- Department of Physical Medicine and Rehabilitation, Bolu Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Nevin Horasan
- Nilüfer Oral and Dental Health Hospital, Bursa, Turkey
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6
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Zapata-Soria M, Cabrera-Martos I, López-López L, Ortiz-Rubio A, Granados-Santiago M, Ríos-Asín I, Valenza MC. Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010657. [PMID: 36613028 PMCID: PMC9819907 DOI: 10.3390/ijerph20010657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 06/01/2023]
Abstract
Background: Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery. The objective of this study was to systematically review all published data that examined the assessment and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke. Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for stomatognathic system disturbances. The methodological quality was evaluated using the Mixed Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The most frequently reported symptoms in patients with stroke included stiffness and thickness of the masseter muscle on the affected side and suprahyoid muscles; facial muscles' asymmetry and weakness; temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva flow rate. The rehabilitation strategies more frequently reported included exercises directed to the jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was 85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on interventions for stomatognathic system disturbances are required before conclusions may be drawn. Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices, given that the results may help to develop early assessment and rehabilitation strategies for stomatognathic disturbances in patients with stroke.
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Affiliation(s)
| | | | - Laura López-López
- Department of Physiotherapy, University of Granada, 18016 Granada, Spain
| | | | | | - Izarbe Ríos-Asín
- Department of Physiotherapy, University of Granada, 18016 Granada, Spain
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7
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Klaic M, Seng E, McGrath R. Factors that influence oral hygiene care with hospitalised stroke patients: a mixed methods study. Disabil Rehabil 2022; 44:7926-7935. [PMID: 34797190 DOI: 10.1080/09638288.2021.2003450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Survivors of stroke experience poor oral health during and following hospitalisation. Health professionals consistently report that oral hygiene is complex. Interventions aiming to improve the delivery of oral hygiene care by health professionals rarely use a theoretically driven approach. This study reports the first phase in an intervention development and uses the action, actor, context, target, time (AACTT) framework and theoretical domains framework (TDF) to understand who needs to do what differently in the delivery of oral hygiene care with hospitalised stroke survivors. METHOD Mixed methods including analysis of oral health policies and clinical guidelines using the AACTT framework, focus group discussions using the TDF and audit of 60 medical records. RESULTS Policies and guidelines lack specificity regarding what oral hygiene care is and who should be responsible. Health professionals have low beliefs in their capabilities and experience numerous contextual barriers. More than 40% of patients had no documented evidence of oral hygiene care. CONCLUSION This study used a theoretically driven approach to identify barriers and enablers to health professional delivery of oral hygiene care with stroke survivors. Interventions aiming to improve clinical practice should target beliefs about capabilities, improved access to resources and detailed oral hygiene clinical guidelines.Implications for rehabilitationSurvivors of stroke experience poor oral health which can contribute to further strokes, cardiovascular disease and mortality.Health care professionals report difficulties in delivering oral hygiene care to hospitalised stroke survivors and clinical guidelines lack detail regarding oral health assessments, interventions and training.Interventions aiming to improve the delivery of oral hygiene care should target health professional beliefs about their capabilities using strategies such as behavioural practice.Resources specific to oral hygiene care for more complex patients, including suctioning toothbrushes, should be readily accessible for health professional use.Clinical guidelines and policies on oral hygiene care should include detail about training content, assessments tools and how to adapt information for patients with complex impairments.
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Affiliation(s)
- Marlena Klaic
- Allied Health Department, Royal Melbourne Hospital, Melbourne, Australia.,Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Erich Seng
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Roisin McGrath
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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8
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Strobelt L, Kuttenreich AM, Volk GF, Beurskens C, Lehmann T, Schüler IM. Oral health and oral health-related quality of life in patients with chronic peripheral facial nerve palsy with synkineses—A case-control-study. PLoS One 2022; 17:e0276152. [PMID: 36395343 PMCID: PMC9671450 DOI: 10.1371/journal.pone.0276152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/07/2022] [Indexed: 11/19/2022] Open
Abstract
Facial nerve palsy (FP) is the most common cranial nerve lesion, leading to partial or complete immobility of the affected half of face. If food residues on tooth surfaces cannot be removed by natural self-cleaning mechanisms that this is likely to lead to an increase dental plaque formation and the risk of dental, periodontal and general diseases. It was the aim of this study to assess oral health, oral hygiene with the influence of handedness and oral health related quality of life in patients with chronic peripheral FP. This study included 86 people. Patients with FP (n = 43) in an FP-group (FPG) were matched with 43 participants without ever diagnosed FP in a control group (CG). Oral health and oral hygiene were assessed in a clinical examination performed in hospital. Decayed-missing-filled-teeth-index, periodontal-screening-index, approximal plaque index and sulcus bleeding index were used to evaluate dental caries and periodontal health status. Oral health-related quality of life data (OHQoL) was collected with the Oral health impact profile (Germany-14) by interview. Oral health parameters in the FPG were significantly worse than in the CG. The median revealed 14.3% more proximal plaque (p = 0.014), 20.8% more sulcus bleeding (p = 0.002) and more than twice as much caries (p = 0.024). The paretic side compared to the non-paretic side of patients was significantly more affected by inflammatory periodontal diseases (p = 0.032) and had a higher prevalence of caries (p = 0.163). Right-handed patients with right-sided FP performed worse than right-handed patients with left-sided FP (p = 0.004). Patients with FP described a greater limitation of OHQoL than patients without this disease (p < 0.001). In conclusion, facial nerve palsy affects oral health, oral hygiene and OHQoL of patients while handedness influences oral hygiene and oral health.
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Affiliation(s)
- Lisa Strobelt
- Section for Preventive Dentistry and Pediatric Dentistry at the Center for Dentistry, Oral and Maxillofacial Surgery of Jena University Hospital, Jena, Germany
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
- Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany
- * E-mail:
| | - Anna-Maria Kuttenreich
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
- Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany
- Center for Rare Diseases Jena, Jena University Hospital, Jena, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
- Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany
- Center for Rare Diseases Jena, Jena University Hospital, Jena, Germany
| | - Carien Beurskens
- Department of Physiotherapy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas Lehmann
- Institute of Medical Statistics, Computer and Data Sciences, University Hospital Jena, Jena, Germany
| | - Ina Manuela Schüler
- Section for Preventive Dentistry and Pediatric Dentistry at the Center for Dentistry, Oral and Maxillofacial Surgery of Jena University Hospital, Jena, Germany
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da Silva GP, Verri ED, Palinkas M, Gonçalves CR, Gonçalves PN, Lopes RFT, Gomes GGC, Regalo IH, Siéssere S, Regalo SCH. Impact of Hemorrhagic Stroke on Molar Bite Force: A Prospective Study. Prague Med Rep 2022; 123:181-187. [PMID: 36107446 DOI: 10.14712/23362936.2022.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Stroke is a neurological deficit of cerebrovascular origin that promotes physical impairments of adult individuals. The present study is aimed to demonstrate whether hemorrhagic stroke affects the maximum molar bite force. The prospective study carried in Centro Universitario Claretiano de Batatais, Brazil, determined the distribution of the sample into two groups: hemorrhagic stroke group (n=18, median age, 62.5 years) and disease-free group (n=18, median age, 62.0 years), with 10 men and 8 women in each group. Subjects were paired one-to-one (age and body mass index). The dynamometer was used to measure the maximum molar bite force (right and left). All analyses were performed with a significance level of 5% (Student's t-test). Differences were found on the right (p=0.048) and left (p=0.042) molar bite force, with lower bite force (both sides) in hemorrhagic stroke group. The study suggests that hemorrhagic stroke negatively affects the maximum molar bite force and necessitates changes in food intake to nutritious and softer consistency foods.
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Affiliation(s)
- Gabriel Pádua da Silva
- School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.,UNIFAFIBE, Bebedouro, Brazil
| | - Edson Donizetti Verri
- Claretiano, University Center of Batatais, Batatais, Brazil.,School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Marcelo Palinkas
- Faculty Anhanguera, Ribeirão Preto, São Paulo, Brazil. .,National Institute for Translational Medicine (INCT-TM), Ribeirão Preto, Brazil. .,School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
| | - Camila Roza Gonçalves
- Hospital do Amor, Barretos, Brazil.,School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Robson Felipe Tosta Lopes
- School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.,UNIFAFIBE, Bebedouro, Brazil
| | | | | | - Selma Siéssere
- National Institute for Translational Medicine (INCT-TM), Ribeirão Preto, Brazil.,School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Simone Cecilio Hallak Regalo
- National Institute for Translational Medicine (INCT-TM), Ribeirão Preto, Brazil.,School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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10
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Shu X, Fan Y, Leung KCM, Lo ECM. Masticatory function of stroke patients: A systematic review with meta-analysis. Gerodontology 2022; 40:172-182. [PMID: 36004768 DOI: 10.1111/ger.12653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The present systematic review and meta-analysis aimed to summarise the current information on the masticatory function of stroke patients. METHODS Four electronic databases (Medline, Embase, CINAHL and Web of Science) were searched for relevant observational studies and clinical trials (up to Jun 2021) on the masticatory function of stroke patients. Two reviewers independently performed study selection and quality assessments (using JBI Critical Appraisal Checklist). Meta-analysis was conducted for the comparison of bite force and masticatory performance using standardised mean difference (SMD). Of the 3837 records identified, nine studies, corresponding to 11 papers and 302 participants, were included in the analysis. RESULTS The maximum bite force of stroke patients was significantly lower than that of the healthy individuals (SMD -0.52, 95% CI: -0.95 to -0.08, P = .02). There was no significant difference between the ipsi-lesional and the contra-lesional sides of the same stroke patient (SMD 0.13, 95% CI: -0.14 to 0.39, P = .34). Stroke patients had lower masticatory performance than healthy people (SMD -0.97, 95% CI: 0.57 to 1.37, P < .00001), and the contra-lesional side was worse than the ipsi-lesional side. Electromyographic analysis indicated that muscle activation of stroke patients was poorer than the healthy individuals, and stroke patients seem to exhibit dysfunction in the recruiting and firing of motor units. CONCLUSIONS Stroke patients have lower maximum bite force and masticatory performance than healthy people, with masticatory performance being the most affected.
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Affiliation(s)
- Xin Shu
- Faculty of Dentistry, The University of Hong Kong. Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Yanpin Fan
- Faculty of Dentistry, The University of Hong Kong. Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong. Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong. Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
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11
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Schimmel M, Rachais E, Al-Haj Husain N, Müller F, Srinivasan M, Abou-Ayash S. Assessing masticatory performance with a colour-mixing ability test using smartphone camera images. J Oral Rehabil 2022; 49:961-969. [PMID: 35730250 PMCID: PMC9545160 DOI: 10.1111/joor.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022]
Abstract
Background Colour‐mixing ability tests are frequently used to assess masticatory performance, but the image acquisition process may be cumbersome and technique sensitive. Objectives To evaluate the reliability of smartphone camera images in assessing masticatory performance using a colour‐mixing ability test. Methods Participants were recruited into three groups of dental state (n = 20 each): fully dentate, removable partial denture wearers and complete denture wearers. After performing a colour‐mixing ability test, images of the gum specimens (Hue‐Check Gum©) were captured with two smartphones and compared with the images obtained from a flatbed scanner by two examiners. The images were analysed with a subjective‐ (SA) and an opto‐electronical assessment (VoH). Inter‐ and intra‐rater reliability were tested. ANOVA models with repeated measures were used for statistical analysis (⍺ = .05). Results All three image acquisition techniques were able to distinguish masticatory performance between different dental states. For SA, inter‐rater reliability was fair to substantial and intra‐rater reliability was substantial to almost perfect. For VoH, inter‐rater reliability with the smartphones was at times different between two examiners, but the intra‐rater assessment was reliable. The opto‐electronic analysis with smartphone images underestimated the masticatory performance significantly when compared to the flatbed scanner analysis. Seven‐day ageing of the specimens did not significantly affect the results. Conclusions The assessment of masticatory performance with the Hue‐Check Gum© is a reliable method. The use of smartphones may occasionally underestimate masticatory performance; image acquisition with a flatbed scanner remains the gold standard. A centralised analysis of the photographed wafer may foster the reliability of the diagnosis.
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Affiliation(s)
- Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Elias Rachais
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nadin Al-Haj Husain
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Clinic of General- Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Fan Y, Shu X, Leung KCM, Lo ECM. Associations of general health conditions with masticatory performance and maximum bite force in older adults: A systematic review of cross-sectional studies. J Dent 2022; 123:104186. [PMID: 35691453 DOI: 10.1016/j.jdent.2022.104186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To give an overview of the current evidence on the associations of general health conditions with masticatory performance and maximum bite force in older adults. DATA/SOURCES Three electronic databases (Medline via PubMed, Embase via Ovid and CINAHL Plus via EBSCOhost) were searched up to September 2021 for cross-sectional studies on general health conditions and masticatory performance or maximum bite force in older adults. Methodological quality of the included studies was independently evaluated based on Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between general health conditions and masticatory performance or maximum bite force were extracted. STUDY SELECTION Of the 5133 records identified, 39 studies (43 articles) were included in this review. Significant negative associations were found between masticatory performance and stroke, sarcopenia, amyotrophic lateral sclerosis, chronic obstructive pulmonary disease, dyspepsia, dysphagia, anorexia, and carotid atherosclerosis. Significant negative association was found between maximum bite force and sarcopenia. There were equivocal results on the association between masticatory performance and diabetes mellitus, and between maximum bite force and stroke, and amyotrophic lateral sclerosis. There was no significant association between masticatory performance and metabolic syndrome, and between maximum bite force and progress of Parkinson's disease. Most studies revealed positive associations of physical function with masticatory performance and maximum bite force. CONCLUSIONS Negative associations between masticatory function of older adults and presence of several systemic diseases have been reported in a number of studies while there are positive associations between masticatory function and some physical function indicators. CLINICAL SIGNIFICANCE This study provides valuable information on the association of masticatory function with general health, which draws clinicians' attention to the masticatory function of older adults who suffer from certain systemic diseases or physical dysfunction, and to the need to improve their masticatory ability to achieve healthy aging.
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Affiliation(s)
- Yanpin Fan
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Xin Shu
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Edward Chin Man Lo
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong.
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13
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Kulvanich S, Sakai H, Takanami R, Yamada M, Sasa A, Ito K, Tsujimura T, Magara J, Inoue M. Impact of oral function on regaining oral intake and adjusting diet forms for acute stroke patients. J Stroke Cerebrovasc Dis 2022; 31:106401. [DOI: 10.1016/j.jstrokecerebrovasdis.2022.106401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 10/19/2022] Open
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Schmalz G, Li S, Ziebolz D. Oral Health-Related Quality of Life in Patients after Stroke—A Systematic Review. J Clin Med 2022; 11:jcm11051415. [PMID: 35268507 PMCID: PMC8911029 DOI: 10.3390/jcm11051415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 12/18/2022] Open
Abstract
Objectives: Aim of this systematic review was to assess oral health-related quality of life (OHRQoL) of patients after stroke. Methods: The systematic literature search was performed on December 2021 based on PubMed, Medline, Web of Science, and Scopus, with the search terms: “oral health-related quality of life” AND stroke OR apoplexy OR ischemic stroke OR apoplectic insult. Articles exclusively examining patients after stroke and reporting a well-documented and valid OHRQoL measurement were included. Results: Out of 68 findings, 8 studies were included. The number of patients ranged between 31 and 549 individuals, mean age between 55.7 and 73.9 years, and 49–72% of individuals were male. Two studies included a healthy control group. Oral health parameters were rarely reported across studies. Five studies reported on the Oral Health Impact Profile (OHIP) 14 for OHRQoL, showing means between 2.87 and 33.0 in sum score. Three studies applied Geriatric Oral Assessment Index (GOHAI), with sum scores between 45.6 and 55.0. Only one study found worse OHRQoL in stroke patients compared to healthy controls. Two studies reported on an association between OHRQoL and general quality of life. Three studies found OHRQoL to be associated with different oral health parameters. Only one study found OHRQoL to be associated with stroke-related parameters. Conclusions: Patients after stroke show a reduced OHRQoL. Medical staff and caregivers should support oral hygiene and dental visits, to foster patients’ oral health and OHRQoL.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
- Correspondence: ; Tel.: +49-341-9721211
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou 510280, China;
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
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Srinivasan M, Kalberer N, Fankhauser N, Naharro M, Maniewicz S, Müller F. CAD-CAM complete removable dental prostheses: A double-blind, randomized, crossover clinical trial evaluating milled and 3D-printed dentures. J Dent 2021; 115:103842. [PMID: 34637889 DOI: 10.1016/j.jdent.2021.103842] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This double-blind, randomized, crossover, clinical trial aimed to evaluate and compare the differences between milled and 3D-printed complete removable dental prostheses (CRDPs). METHODS Fifteen edentulous patients (men: n = 10, women: n = 5; age: 66.7 ± 8.0 years) rehabilitated with conventional CRDPs were recruited for this trial. Participants were randomized to first receiving either the milled or 3D-printed CAD-CAM manufactured CRDPs and then after 6-weeks cross over to the other set. Both, clinicians and participants were blinded to the group allocation. Outcomes included patient's denture satisfaction (PDS), oral-health related quality of life (OHIP-EDENT), willingness-to-pay analysis, final choice (FC) of CRDPs, clinician's denture quality evaluation (CDQE), chewing efficiency (CE), maximum-voluntary-bite-force (MBF), and prosthodontic maintenance needs. The outcomes were measured at baseline (with old CRDPs), at 1 and 6 weeks after new CRDP insertion; following crossover with the second set of CRDPs, an identical protocol was followed. Generalized linear regression for repeated measures was used for statistical analysis with α=0.05. RESULTS All participants completed the trial. 3D-printed CRDPs required more maintenance visits, adjustment time (p = 0.0003), and adjustment costs (p = 0.021). Patients were willing-to-pay an average of 606.67 Swiss Francs more than the actual cost for the milled CRDPs. There were no differences in the PDS, OHIP, FC, CDQE, CE, and MBF between the two CRDPs groups. CONCLUSIONS The findings of this double-blind randomized crossover clinical trial confirm that both milled and 3D-printed CRDPs are valid treatment modalities for edentulous patients, with the latter performing inferiorly with regard to the time and costs involved with the prosthodontic aftercare, as well as the patients' willingness-to-pay. CLINICAL RELEVANCE The findings of this trial provide evidence to help the clinician in choosing the appropriate CAD-CAM manufacturing process for fabricating the CRDPs.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General, Special care, and Geriatric dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland.
| | - Nicole Kalberer
- Clinic of General, Special care, and Geriatric dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Nicolas Fankhauser
- Clinic of General, Special care, and Geriatric dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Manuel Naharro
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland; Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Chemin du Pont-Bochet 3, 1226 Thônex, Switzerland
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16
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Matsuo K, Sekimoto Y, Okamoto M, Shibata S, Otaka Y. Association between oral health status and oral food intake level in subacute stroke patients admitted to a convalescent rehabilitation unit. Gerodontology 2021; 39:67-73. [PMID: 34448242 DOI: 10.1111/ger.12586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stroke patients often suffer from dysphagia during their recovery. We hypothesised that subacute stroke patients with dysphagia had more deteriorated oral health status including muscle strength and motor function. OBJECTIVE Quantitatively investigate oral health status and identify associations with oral feeding status in stroke patients admitted to a convalescent rehabilitation unit. METHODS We prospectively recruited 187 stroke patients admitted to a convalescent rehabilitation unit. Oral feeding status was examined using the Functional Oral Intake Scale (FOIS), and the cohort was divided into three groups based on FOIS score as non-oral feeding (FOIS-123; 22 patients), dysphagic diet (FOIS-45; 74 patients), and regular diet (FOIS-67; 91 patients) groups. Activities of daily living (ADL) were assessed with the Functional Independence Measure (FIM). Oral health status was measured quantitatively in six oral function parameters and Oral Health Assessment Tool (OHAT), and differences according to the FOIS, age and FIM were statistically tested. RESULTS In bivariate analysis, two parameters, tongue pressure and tongue-lip motor functions were significantly higher in the regular diet group than in the other groups (P < .01). Gross OHAT score was also significantly better in the regular diet group than in the other groups (P < .01). These significant associations mostly remained in the multiple model after adjusting for age and FIM. CONCLUSION This study suggests that, amongst oral health status, tongue strength and motor function, as well as OHAT score, may have strong associations with oral feeding status in subacute stroke patients at convalescent rehabilitation units regardless of ADL levels.
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Affiliation(s)
- Koichiro Matsuo
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan.,Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Sekimoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Mieko Okamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
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17
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Gonçalves TMSV, Schimmel M, van der Bilt A, Chen J, van der Glas HW, Kohyama K, Hennequin M, Peyron MA, Woda A, Leles CR, José Pereira L. Consensus on the terminologies and methodologies for masticatory assessment. J Oral Rehabil 2021; 48:745-761. [PMID: 33638156 PMCID: PMC8252777 DOI: 10.1111/joor.13161] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 02/06/2023]
Abstract
A large number of methodological procedures and experimental conditions are reported to describe the masticatory process. However, similar terms are sometimes employed to describe different methodologies. Standardisation of terms is essential to allow comparisons among different studies. This article was aimed to provide a consensus concerning the terms, definitions and technical methods generally reported when evaluating masticatory function objectively and subjectively. The consensus is based on the results from discussions and consultations among world‐leading researchers in the related research areas. Advantages, limitations and relevance of each method are also discussed. The present consensus provides a revised framework of standardised terms to improve the consistent use of masticatory terminology and facilitate further investigations on masticatory function analysis. In addition, this article also outlines various methods used to evaluate the masticatory process and their advantages and disadvantages in order to help researchers to design their experiments.
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Affiliation(s)
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology / School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andries van der Bilt
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jianshe Chen
- Laboratory of Food Oral Processing, Zhejiang Gongshang University, Hangzhou, China
| | | | - Kaoru Kohyama
- Food Research Institute, National Agriculture and Food Research Organization (NARO), Tsukuba, Japan
| | | | - Marie-Agnès Peyron
- University of Clermont Auvergne, Clermont-Ferrand, France.,INRAE Centre, Human Nutrition Unit, Université of Clermont Auvergne, Clermont-Ferrand, France
| | - Alain Woda
- University of Clermont Auvergne, Clermont-Ferrand, France
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18
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Kothari SF, Nascimento GG, De Caxias FP, Jakobsen MB, Nielsen JF, Kothari M. Changes in oral health related quality of life and its associated factors in individuals with brain injury. Brain Inj 2021; 35:718-724. [PMID: 33645361 DOI: 10.1080/02699052.2021.1891289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose: To evaluate changes in oral health-related quality of life (OHRQoL) and associated factors in individuals with acquired brain injury (ABI) during hospitalization.Methods: Forty-six individuals with ABI were examined at week 1 and 5 of hospitalization. OHRQoL was recorded through Oral Health Impact Profile-14 (OHIP-14), clinical oral examinations were conducted, while orofacial health-related 'motor' and 'cognitive' scores were retrieved from patients' e-journal. Association between variables were investigated using factor analysis and multilevel regression modeling.Results: There were no significant differences in the OHIP-14 scores between week 1 and 5. Factors analysis revealed two OHIP-14 domains, 'psychosocial' and 'physica'. Individuals who improved their cognitive skills over study period and those with 'severe' periodontitis at baseline had increased scores of OHIP-14 'psychosocial' domain. Individuals who improved orofacial health-related 'motor' skills over study period had decreased 'physical' domain scores. Increased cognition over study period, current smoking and dental calculus were associated with increased 'physical' domain.Conclusions: The OHRQoL was poor both at week 1 and 5. Individual's cognitive and motor skills as well as their oral health status influenced their OHRQoL. Thus, individual's awareness and involvement in addition to oral care seem to be imperative in improving the OHRQoL in neurorehabilitation setting.
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Affiliation(s)
- Simple F Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.,Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Fernanda P De Caxias
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Mille B Jakobsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark
| | - Jørgen F Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark
| | - Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.,JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
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19
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Srinivasan M, Schimmel M, Buser R, Maniewicz S, Herrmann FR, Müller F. Mandibular two-implant overdentures with CAD-CAM milled bars with distal extensions or retentive anchors: A randomized controlled trial. Clin Oral Implants Res 2020; 31:1207-1222. [PMID: 32965052 DOI: 10.1111/clr.13668] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This randomized controlled trial (RCT) aimed to demonstrate the non-inferiority of mandibular 2-implant overdentures (IODs) on a CAD-CAM milled bar with long distal extensions (MBDE) against IODs on retentive anchors (RA). METHODS Forty edentulous participants rehabilitated with a maxillary conventional denture and a mandibular 2-IOD participated in this trial. They were randomized into two groups [Control group (CG): RA + gold matrices; Experimental group (EG): MBDE + gold clip]. The outcomes included implant survival rate (ISR), chewing efficiency [quantitative (VoH) and subjective (SA) assessments], peri-implant marginal bone levels (PI-MBL), maximum bite force (MBF), and patient-reported outcomes [oral health impact profile (OHIP-EDENT), and denture satisfaction index (DSI)]. Outcomes were recorded at baseline (BL), two weeks (T0 ), 6 months (T1 ), and at 1 year (T2 ) after the intervention. Intra- and inter-group analyses were performed using regression models with ⍺=0.05. RESULTS 38 participants completed the T2 visit (CG: n = 19, age = 74.7 ± 7.8 years; EG: n = 19, age = 70.3 ± 10.7 years). At T2 , there was no implant loss in either of the groups (ISR = 100%). There were no significant differences between the groups for the PI-MBL changes (p = .754). Improvements occurred faster in the EG than in the CG, but over the observation time, there were no differences between the trial groups for VoH, MBF, OHIP-EDENT, and the DSI, except for SA being significantly better in the EG group (p = .022). CONCLUSIONS The results of this RCT confirm that mandibular 2-IODs with a CAD-CAM milled bar with long distal extensions are not an inferior treatment to the conventional IODs on retentive anchors in the short term (1 year).
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Affiliation(s)
- Murali Srinivasan
- Center of General, Special Care, & Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ramona Buser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatics, Geneva University Hospitals, Trois-Chêne, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Service of Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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20
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Su N, van Wijk A, Visscher CM. Psychosocial oral health-related quality of life impact: A systematic review. J Oral Rehabil 2020; 48:282-292. [PMID: 32761938 PMCID: PMC7984127 DOI: 10.1111/joor.13064] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 06/10/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022]
Abstract
Background Psychosocial wellbeing is an important determinant for patients' oral health‐related quality of life (OHRQoL). Psychosocial impact (PI), together with the dimensions Oral Function, Orofacial Pain and Orofacial Appearance, has been proposed to cover the different areas of OHRQoL. Objective The objective of the study was to collect further scientific support for the new four‐dimensional structure of OHRQoL. This study is one out of a series of four and focuses on the PI in patients with dental anxiety, oral cancer and periodontitis (PROSPERO registration number: CRD42017064033). Methods Five databases (Pubmed (Medline), EMBASE, Cochrane, CINAHL and PsycINFO) were electronically searched on 8 June 2017 and updated on 14 January 2019, to identify the studies that measure OHRQoL using the Oral Health Impact Profile (OHIP) for oral health conditions. In this review, studies were included if the mean/median domain scores from OHIP‐14 or OHIP‐49 were available for patients with dental anxiety, oral cancer or periodontitis. The score of the handicap domain from the OHIP was used to assess patients` PI. The handicap domain includes 6 items for OHIP‐49 with a domain score ranging from 0 to 24 and 2 items for OHIP‐14 with a domain score ranging from 0 to 8. For comparison between the 2 versions of the OHIP, the domain score of OHIP‐49 was conversed into a 0 to 8 metric. The domain scores of the included studies were then pooled, separately for each of the included dental disorders. Results A total of 2104 records were identified based on the search strategy. After screening of titles and abstracts, 1607 articles were reviewed in full text. Twenty‐three articles met the inclusion criteria for this review and were included in the study. The 23 articles contained 3884 patients, grouped in 30 patient populations and 42 patient samples. The pooled mean scores of PI for dental anxiety, oral cancer and periodontitis were 3.2, 1.9 and 0.8, respectively, on the 0 to 8 metric. Conclusion This review provides standardised information about the OHRQoL impact for three dental disorders as a model for the PI dimension. Dental anxiety tends to show the strongest effect on the PI dimension, while periodontitis tends to show the weakest effect on the PI dimension. Future studies need to confirm whether the reported differences in PI scores between the three dental disorders are statistically significant.
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Affiliation(s)
- Naichuan Su
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Arjen van Wijk
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Corine M Visscher
- Department of Orofacial Pain and Disfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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21
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O'Malley L, Powell R, Hulme S, Lievesley M, Westoby W, Zadik J, Bowen A, Brocklehurst P, Smith CJ. A qualitative exploration of oral health care among stroke survivors living in the community. Health Expect 2020; 23:1086-1095. [PMID: 32558061 PMCID: PMC7696142 DOI: 10.1111/hex.13074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 04/23/2020] [Accepted: 04/30/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dental disease is highly prevalent in people with stroke. Stroke survivors regard oral hygiene as an important, yet neglected, area. The aim was to explore experiences of and barriers to oral care, particularly in relation to oral hygiene practice and dental attendance, among stroke survivors in the community. METHODS This was a qualitative study incorporating a critical realist approach. Interviews were conducted with community-dwelling stroke survivors requiring assistance with activities of daily living, and focus groups were held with health and care professionals. Interviews and focus groups were recorded and transcribed verbatim. Thematic analysis was conducted. RESULTS Twenty-three stroke survivors were interviewed, and 19 professionals took part in 3 focus groups. Professionals included nurses, speech and language therapists, occupational therapists, dieticians, professional carers and dental staff. Interviews revealed difficulties in carrying out oral hygiene self-care due to fatigue, forgetfulness and limb function and dexterity problems. Routine was considered important for oral hygiene self-care and was disrupted by hospitalization resulting from stroke. Professionals highlighted gaps in staff training and confidence in supporting patients with oral care. Access to dental services appeared particularly problematic for those who were not registered with a dentist pre-stroke. CONCLUSION Oral hygiene routines may be disrupted by stroke, and resulting disabilities may make regular oral self-care more difficult. This study has identified specific barriers to oral hygiene self-care and dental service access. Findings from this study are feeding into the development of an intervention to support stroke survivors with oral care.
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Affiliation(s)
- Lucy O'Malley
- Division of Dentistry, School of Medical Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Rachael Powell
- Division of Psychology & Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Sharon Hulme
- Division of Cardiovascular Sciences, School of Medical Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.,Salford Royal NHS Foundation Trust, Salford, UK
| | | | | | - Jess Zadik
- Salford Royal NHS Foundation Trust, Salford, UK
| | - Audrey Bowen
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | | | - Craig J Smith
- Salford Royal NHS Foundation Trust, Salford, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, Lydia Becker Institute of Immunology and Inflammation, Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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22
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The Impact of Gross Motor Function on the Oral Health-Related Quality of Life in Young Adults with Cerebral Palsy in Saudi Arabia. Int J Dent 2020; 2020:4590509. [PMID: 32190052 PMCID: PMC7064833 DOI: 10.1155/2020/4590509] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/29/2020] [Accepted: 02/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background There is evidence that gross motor function impacts the health-related quality of life of young adults with cerebral palsy. This study aimed to assess gross motor function, oral health and oral health-related quality of life (OHRQoL), and the relationship between them in young adults with cerebral palsy. Methods The sample comprised 46 individuals aged between 13 and 17 years with Gross Motor Function Classification Scores (GMFCS) ranging from level I to level III. The individuals and their parents were administered an Arabic version of the child perception questionnaire for adolescents. Parental and child perception scores, DMFT, and gingival index were compared across GMFCS levels using the one-way ANOVA and Scheffe's post hoc test. Results Children with level III GMFCS had a significantly higher child perception score (CPQ) and parental perception score (PPQ) than those with level I or level II scores. There was a significant association between function (GMFCS) and the CPQ score in children (p = 0.016). No significant associations were found between the CPQ score and either dental caries (DMFT) or gingival bleeding (GI) scores. Children with GMFCS level III had a significantly higher DMFT (p = 0.016). No significant associations were found between the CPQ score and either dental caries (DMFT) or gingival bleeding (GI) scores. Children with GMFCS level III had a significantly higher DMFT (p = 0.016). No significant associations were found between the CPQ score and either dental caries (DMFT) or gingival bleeding (GI) scores. Children with GMFCS level III had a significantly higher DMFT ( Conclusion Motor function has a significant impact on both the oral health and the OHRQoL of adolescents and young adults with spastic cerebral palsy.
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Temporomandibular Joint Dysfunction and Impaired Stomatognathic Alignment: A Problem Beyond Swallowing in Patients With Stroke. Indian J Otolaryngol Head Neck Surg 2020; 72:329-334. [PMID: 32728543 DOI: 10.1007/s12070-020-01830-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/05/2020] [Indexed: 10/24/2022] Open
Abstract
The aim of this study is to evaluate the efficacy of supervised structured exercise programme in post stroke patients with temporomandibular joint dysfunction (TMJD). 30 post stroke patients diagnosed as TMJD according to "diagnostic criteria for temporomandibular disorders" (DC/TMD) were included for the study. A structured exercise programme including active and active-assisted range of motion (ROM) exercises for neck and temporomandibular joint (TMJ), chins tuck exercises, breathing and relaxing exercises and posture exercises were performed. Cervical ROMs including flexion, extansion, lateral flexion and rotation, Mann assessment of swallowing ability (MASA) and mini mental state exam (MMSE) scores, maximal mouth opening (MMO) and craniomandibular index (CMI) of the patients compared at baseline, 1st and 6th month after supervised rehabilitation procedure. All parameters were significantly improved both in 1st and 6th month evaluation. At 6th month evaluation, the cervical ROMs of the patients improved from severe to mild restriction (p = 0.001), the mean MASA score of the patients improved from moderate to mild swallowing disorder (p = 0.001), mean MMSE score of 30 patients was accepted as normal (p = 0.001), mean MMO of the patients was 56.00 ± 4.84 mm and mean CMI was 0.16 ± 0.05 indicating that the patients had a "mild" limitation in mouth opening and "mild" dysfunction in TMJ (p = 0.001 respectively). Our structured supervised exercise programme improves swallowing quality by establishing proper stomatognathic alignment and TMJ function.
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Moreno Sancho F, Tsakos G, Brealey D, Boniface D, Needleman I. Development of a tool to assess oral health-related quality of life in patients hospitalised in critical care. Qual Life Res 2019; 29:559-568. [PMID: 31655973 PMCID: PMC6994456 DOI: 10.1007/s11136-019-02335-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2019] [Indexed: 11/25/2022]
Abstract
AIMS AND OBJECTIVES Oral health deteriorates following hospitalisation in critical care units (CCU) but there are no validated measures to assess effects on oral health-related quality of life (OHQoL). The objectives of this study were (i) to develop a tool (CCU-OHQoL) to assess OHQoL amongst patients admitted to CCU, (ii) to collect data to analyse the validity, reliability and acceptability of the CCU-OHQoL tool and (iii) to investigate patient-reported outcome measures of OHQoL in patients hospitalised in a CCU. METHODS The project included three phases: (1) the development of an initial questionnaire informed by a literature review and expert panel, (2) testing of the tool in CCU (n = 18) followed by semi-structured interviews to assess acceptability, face and content validity and (3) final tool modification and testing of CCU-OHQoL questionnaire to assess validity and reliability. RESULTS The CCU-OHQoL showed good face and content validity and was quick to administer. Cronbach's alpha was 0.72 suggesting good internal consistency. For construct validity, the CCU-OHQoL was strongly and significantly correlated (correlation coefficients 0.71, 0.62 and 0.77, p < 0.01) with global OHQoL items. In the validation study, 37.8% of the participants reported a deterioration in self-reported oral health after CCU admission. Finally, 26.9% and 31% of the participants reported considerable negative impacts of oral health in their life overall and quality of life, respectively. CONCLUSIONS The new CCU-OHQoL tool may be of use in the assessment of oral health-related quality of life in CCU patients. Deterioration of OHQoL seems to be common in CCU patients.
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Affiliation(s)
- Federico Moreno Sancho
- Unit of Periodontology, UCL Eastman Dental Institute, 1st Floor Levy wing, 256 Gray's Inn Road, London, WC1X 8LD, UK.
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, 1 - 19 Torrington Place, London, WC1E 7HB, UK
| | - David Brealey
- Bloomsbury Institute of Intensive Care Medicine, UCL, London, UK
| | - David Boniface
- Epidemiology and Public Health, UCL Eastman Dental Institute, University College London, 256 Gray's Inn Road, London, WC1X 8LD, UK
- Biostatistics, UCL Eastman Dental Institute, UCL, 256 Gray's Inn Road, London, WC1X 8LD, UK
| | - Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, 1st Floor Levy wing, 256 Gray's Inn Road, London, WC1X 8LD, UK
- Centre for Oral Health and Performance, UCL Eastman Dental Institute, UCL, 256 Gray's Inn Road, London, WC1X 8LD, UK
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Zeng LN, Rao WW, Luo SH, Zhang QE, Hall BJ, Ungvari GS, Chen LG, Xiang YT. Oral health in patients with stroke: a meta-analysis of comparative studies. Top Stroke Rehabil 2019; 27:75-80. [PMID: 31566117 DOI: 10.1080/10749357.2019.1656413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective: This meta-analysis systematically analyzed and compared oral health between stroke patients and controls.Data source: The electronic databases of PubMed, EMBASE, PsycINFO, Medline and Web of Science were independently searched by two authors from their inception to 14 June 2018.Study selection: Eleven studies comparing oral health between stroke patients (n = 1,742) and controls (n = 1,193) were analyzed.Data extraction: The full texts of the 11 studies were independently reviewed. Data on oral health were independently extracted by two authors.Data synthesis: Mean differences (MD) and 95% confidence intervals (CI) were calculated and synthesized using fixed or random-effects models, as appropriate. Compared to controls, stroke patients had poorer oral health: they had more Dental Caries (5 studies; MD = 2.89, 95% CI: 0.91-4.88, p= .04), but less Remaining Teeth scores (6 studies; MD = -2.93, 95% CI: -3.91, -1.95; p < .00001). Both the Plaque Index (3 studies; MD = 0.21, 95% CI: 0.14, 0.28; p < .00001) and Gingival Index scores (4 studies; MD = 0.22, 95% CI: 0.14, 0.30; p < .00001) were significantly higher in stroke patients, indicating worse periodontal status.Conclusions: Stroke patients had poorer overall oral health status compared to controls. Given the importance of oral health to overall health, further research on screening for oral health problems after stroke should be conducted and effective management strategies should be devised and implemented.
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Affiliation(s)
- Liang-Nan Zeng
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, China.,Center for Cognition and Brain Sciences, University of Macau, Taipa, China.,Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University; Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province; Sichuan, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, China.,Center for Cognition and Brain Sciences, University of Macau, Taipa, China
| | - Shi-Hong Luo
- Department of Oral implant, The Affiliated Stomatology Hospital of Southwest Medical University, Sichuan, China
| | - Qing-E Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Taipa, China.,Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.,University of Notre Dame Australia, Fremantle, Australia
| | - Li-Gang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University; Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province; Sichuan, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, China.,Center for Cognition and Brain Sciences, University of Macau, Taipa, China
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Relationship between anxiety/depression and oral health-related quality of life in inpatients of convalescent hospitals. Odontology 2018; 107:254-260. [PMID: 30317463 DOI: 10.1007/s10266-018-0394-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
Abstract
The aim of this study is to examin the association between anxiety/depressive tendency and oral health-related quality of life in inpatients of convalescent wards. This cross-sectional study included inpatients of convalescent wards (age range 34-100 years). Data on age, sex, functional independence measure, number of teeth, odontotherapy status, and primary disease for which hospitalization was required were collected. The Hospital Anxiety and Depression Scale (HADS) was used to assess emotional distress. The oral health-related quality of life was evaluated by the Geriatric Oral Health Assessment Index (GOHAI). Oral hygiene level was assessed by the Oral Health Assessment Tool (OHAT). We performed a multiple regression analysis to assess relationships among HADS, GOHAI, and OHAT. Following the analysis, causal connections of these factors were evaluated with structural equations modeling. The scores of GOHAI and OHAT in the caseness cohort (HADS score > 11) were significantly worse than those in the non-caseness cohort (HADS score < 7). Multiple regression analysis revealed that GOHAI was a statistically significant predictor of HADS score (p = 0.012), and that HADS and OHAT scores were predictors of GOHAI (p = 0.012 and < 0.001, respectively), adjusted by sex and age. We found that a model connected from OHAT to HADS through GOHAI was a good fit for the data of inpatients. Oral health-related quality of life, affected by oral hygiene status, was strongly associated with emotional distress in inpatients of convalescent wards. Daily oral care and assessment by healthcare professionals can reduce the emotional distress of inpatients in convalescent wards.
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Lyons M, Smith C, Boaden E, Brady MC, Brocklehurst P, Dickinson H, Hamdy S, Higham S, Langhorne P, Lightbody C, McCracken G, Medina-Lara A, Sproson L, Walls A, Watkins DC. Oral care after stroke: Where are we now? Eur Stroke J 2018; 3:347-354. [PMID: 31236482 DOI: 10.1177/2396987318775206] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 04/12/2018] [Indexed: 01/25/2023] Open
Abstract
Purpose There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia - a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice. Methods A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities.Findings: Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care. Discussion Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae. Conclusion Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke. Clinically relevant, feasible, cost-effective, evidence-based oral care interventions to improve patient outcomes in stroke care are urgently needed.
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Affiliation(s)
- Mary Lyons
- Faculty of Health and Wellbeing, University of Central Lancashire, UK.,Department of International Public Health, Liverpool School of Tropical Medicine, UK
| | - Craig Smith
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, UK.,Department of Neurosciences, Salford Royal NHS Foundation Trust, UK
| | - Elizabeth Boaden
- Faculty of Health and Wellbeing, University of Central Lancashire, UK
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, UK
| | - Paul Brocklehurst
- North Wales Organisation for Randomised Trials in Health, Bangor Institute of Health and Medical Research and Salford Royal NHS Foundation Trust, UK
| | - Hazel Dickinson
- Faculty of Health and Wellbeing, University of Central Lancashire, UK
| | - Shaheen Hamdy
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Susan Higham
- Institute of Psychology, Health and Society, University of Liverpool, UK
| | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | | | - Giles McCracken
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, UK
| | | | - Lise Sproson
- National Institute for Health Research Devices for Dignity Healthcare Technology Cooperative, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Angus Walls
- Edinburgh Dental Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | - Dame Caroline Watkins
- Faculty of Health and Wellbeing, University of Central Lancashire, UK.,Faculty of Health Sciences, Australian Catholic University, Australia
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Kim HT, Park JB, Lee WC, Kim YJ, Lee Y. Differences in the oral health status and oral hygiene practices according to the extent of post-stroke sequelae. J Oral Rehabil 2018; 45:476-484. [PMID: 29663483 DOI: 10.1111/joor.12634] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 11/28/2022]
Abstract
Oral health and hygiene are crucial parameters in stroke patients. However, few studies have evaluated the oral health status and oral hygiene practices according to the level of function in stroke patients. The aim of this study was to evaluate the oral health status and oral hygiene practices according to ambulation and personal hygiene levels in patients with stroke. Data from the fifth (2010-2012) and sixth (2013-2015) editions of the Korea National Health and Nutrition Examination Survey (KNHANES) for 6 years were combined. A total of 700 stroke patients were enrolled in our study. Subjective oral health was significantly poorer in patients who experienced a moderate problem with walking (adjusted OR [AOR], 1.68; 95% CI, 1.21-2.33) and bed-bound patients (AOR, 2.92; 95% CI, 1.01-8.44) than in patients who could walk without difficulty. Patients who were unable to bathe or dress independently exhibited a significantly higher risk of dental caries than did those who could perform the same activities unassisted. The probability of brushing teeth ≥2 times daily was 69% lower in bed-bound patients (AOR, 0.31; 95% CI, 0.11-0.87) than in patients who could walk without difficulty and 76% lower in patients who were unable to bathe or dress independently (AOR, 0.24; 95% CI, 0.09-0.62) than in those who could perform the same activities without difficulty. There were differences in oral health status and oral hygiene practices, according to ambulation level and functional independence, in the stroke patient group. These results indicate the need for oral care for stroke patients who exhibit ambulatory and functional limitations.
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Affiliation(s)
- H T Kim
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - J B Park
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - W C Lee
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Y J Kim
- Department of Dental Hygiene, Graduate School, Yonsei University, Seoul, Korea.,Department of Health Administration, Graduate School, Yonsei University, Wonju, Korea
| | - Y Lee
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
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29
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Dursun Ö, Çankaya T. Assessment of Temporomandibular Joint Dysfunction in Patients with Stroke. J Stroke Cerebrovasc Dis 2018; 27:2141-2146. [PMID: 29650380 DOI: 10.1016/j.jstrokecerebrovasdis.2018.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 11/26/2022] Open
Abstract
GOAL The aim of this study was to assess temporomandibular joint dysfunction in patients with stroke. MATERIALS AND METHODS Total of 100 participants, 50 healthy and 50 who had stroke, were recruited into this study. Digital caliper and algometer were used to assess temporomandibular joint range of motion and masticatory muscle pressure pain threshold. Labial commissure angle measurement was used for the assessment of facial paralysis severity. Fonseca questionnaire was used for temporomandibular joint dysfunction assessment and categorization. In addition, dominant mastication shift was measured by the question that asks the pre and poststroke dominant mastication side. FINDINGS In intergroup comparison, significant decrease was found in all temporomandibular range of motion parameters in favor of stroke group (P < .05). Despite the fact that no significant difference was found between groups for the pain threshold in masticatory muscles except for middle part of the left temporalis muscle, values were higher in healthy group (P > .05). As a result of intergroup examination of labial commissure angle degree, Fonseca questionnaire score, it was found that labial commissure angle and Fonseca questionnaire scores were higher in stroke group (P < .05). Intragroup examination of patients with stroke showed that dominant mastication side shift was seen in patients with stroke (P < .05). CONCLUSION It was concluded that, temporomandibular joint dysfunction prevalence was higher in stroke group compared with healthy group and use of modalities specific to temporomandibular joint dysfunction treatment would be beneficial.
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Affiliation(s)
- Ömer Dursun
- School of Physical Therapy and Rehabilitation, Abant Izzet Baysal University, Bolu, Turkey
| | - Tamer Çankaya
- School of Physical Therapy and Rehabilitation, Abant Izzet Baysal University, Bolu, Turkey.
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30
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Schimmel M, Ono T, Lam OLT, Müller F. Oro-facial impairment in stroke patients. J Oral Rehabil 2017; 44:313-326. [PMID: 28128465 DOI: 10.1111/joor.12486] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 01/10/2023]
Abstract
Stroke is considered one of the leading causes of death and acquired disability with a peak prevalence over the age of 80 years. Stroke may cause debilitating neurological deficiencies that frequently result in sensory deficits, motor impairment, muscular atrophy, cognitive deficits and psychosocial impairment. Oro-facial impairment may occur due to the frequent involvement of the cranial nerves' cortical representation areas, central nervous system pathways or motoneuron pools. The aim of this narrative, non-systematic review was to discuss the implications of stroke on oro-facial functions and oral health-related quality of life (OHRQoL). Stroke patients demonstrate an impaired masticatory performance, possibly due to reduced tongue forces and disturbed oral sensitivity. Furthermore, facial asymmetry is common, but mostly discrete and lip restraining forces are reduced. Bite force is not different between the ipsi- and contra-lesional side. In contrast, the contra-lesional handgrip strength and tongue-palate contact during swallowing are significantly impaired. OHRQoL is significantly reduced mainly because of the functional impairment. It can be concluded that impaired chewing efficiency, dysphagia, facial asymmetry, reduced lip force and OHRQoL are quantifiable symptoms of oro-facial impairment following a stroke. In the absence of functional rehabilitation, these symptoms seem not to improve. Furthermore, stroke affects the upper limb and the masseter muscle differently, both, at a functional and a morphological level. The rehabilitation of stroke survivors should, therefore, also seek to improve the strength and co-ordination of the oro-facial musculature. This would in turn help improve OHRQoL and the masticatory function, subsequently preventing weight loss and malnutrition.
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Affiliation(s)
- M Schimmel
- Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - T Ono
- Division of Comprehensive Prosthodontics, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - O L T Lam
- Department of Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - F Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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31
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Huanca Ghislanzoni L, Leemann B, Christou P, Müller F, Schimmel M, Kiliaridis S. Palatal morphology changes in post-stroke patients measured by geometric morphometrics. J Oral Rehabil 2017; 44:172-177. [PMID: 28094863 DOI: 10.1111/joor.12484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2017] [Indexed: 12/01/2022]
Abstract
This study aimed to describe longitudinal palatal shape changes in post-stroke patients when compared to a sample of healthy subjects through linear measurements and geometric morphometrics. The 3D palatal scanned models of seven stroke patients having a 1-year post-stroke follow-up were matched with seven control subjects of the same age group (range 50-87 years). Intercanine, intermolar distances and palatal height were measured. 3D images were also analysed through geometric morphometrics to assess changes in the shape of the palate from T0 to T1 (1 year after the stroke). Principal component analysis was used to describe shape morphology changes, and visual colour maps were used to qualitatively assess differences between T0 and T1. No changes were detected nor in linear measures neither in palatal shape in healthy subjects from T0 to T1. The palates of stroke patients showed no linear differences either. However, when visualising shape changes through colour maps, the lateral aspects of the palatal vault were slightly narrower in T1, with respect to T0 in stroke patients. This may be attributed to altered tongue function following the stroke.
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Affiliation(s)
| | - B Leemann
- Department for Clinical Neurosciences, University of Geneva, Geneva, Switzerland
| | - P Christou
- Department of Orthodontics, University of Geneva, Geneva, Switzerland
| | - F Müller
- Department of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - M Schimmel
- Division of Gerodontology, University of Bern, Bern, Switzerland
| | - S Kiliaridis
- Department of Orthodontics, University of Geneva, Geneva, Switzerland
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Kothari M, Pillai RS, Kothari SF, Spin-Neto R, Kumar A, Nielsen JF. Oral health status in patients with acquired brain injury: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:205-219.e7. [PMID: 27989711 DOI: 10.1016/j.oooo.2016.10.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/16/2016] [Accepted: 10/31/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To undertake a systematic review of the current knowledge and future perspectives regarding the status of various oral health factors, including social and behavioral aspects, in patients with acquired brain injury (ABI). STUDY DESIGN A structured search strategy was applied to PubMed, Embase, and Scopus electronic databases until January 2016 to identify studies presenting assessments of the oral health status of patients afflicted with any kind of ABI. The search strategy was restricted to English-language publications that enrolled patients aged more than 18 years. Studies on the association of oral health conditions and brain injury were excluded. No study was excluded based on its qualitative analysis. RESULTS A total of 27 studies were reviewed. Stroke was the most commonly studied ABI. Stroke patients had a higher number of missing teeth, poorer plaque and gingival index scores, and higher colonization of Candida albicans in saliva, all of which were significantly reduced after intervention. Oral health-related quality of life was poorer in patients compared to the general population. CONCLUSION Stroke was the most predominant brain injury condition studied in the literature, with few publications focusing on other forms of brain injury. Overall, oral health has been noted to be poor in patients with ABI, but oral hygiene and oral health-related quality of life have been found to improve when oral hygiene interventions are provided to patients.
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Affiliation(s)
- Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
| | - Rajath Sasidharan Pillai
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Hammel, Denmark
| | - Simple Futarmal Kothari
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Hammel, Denmark
| | - Rubens Spin-Neto
- Section of Oral Radiology, Institute of Odontology and Oral Health, Aarhus University, Denmark
| | - Abhishek Kumar
- Section of Oral Rehabiliation, Department of Dental Medicine, Karolinska Institute, Sweden
| | - Jørgen Feldbæk Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
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33
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Pakpour AH, Kumar S, Scheerman JFM, Lin CY, Fridlund B, Jansson H. Oral health-related quality of life in Iranian patients with spinal cord injury: A case-control study. Injury 2016; 47:1345-52. [PMID: 27085836 DOI: 10.1016/j.injury.2016.03.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The study aimed to compare the oral health variables, general, and oral health-related quality of life (QoL), depression, and anxiety between spinal cord injury (SCI) patients and healthy controls and also to determine the key factors related to the oral health-related quality of life (OHRQoL) in the SCI patients. METHODS A total of 203 SCI patients and 203 healthy controls were enrolled. Patients and healthy adults were invited to attend a dental clinic to complete the study measures and undergo oral clinical examinations. OHRQoL was assessed by the 14-item Oral Health Impact Profile (OHIP-14), and the general health-related quality of life (GHRQoL) was evaluated by SF-36. In SCI patients, depression and anxiety were recorded using the Hospital Anxiety and Depression Scale (HADS), while Functional Assessment Measure (FAM) was used to assess dependence and disability. All the subjects were examined for caries which was quantified using the decayed, missing, and filled Teeth (DMFT) index, gingival bleeding index (GI), plaque index, and periodontal status by community periodontal index (CPI). RESULTS The analysis of covariance (ANCOVA) revealed significant differences between the two groups in terms of oral health expressed in DMFT, oral hygiene, and periodontal status, controlled for age, gender, family income, and occupational status (p<0.001). Using the hierarchical linear regression analyses, in the final model, which accounted for 18% of the total variance (F(126.7), p<0.01), significant predictors of OHRQoL were irregular tooth brushing (β=1.23; 95% CI=1.06; 1.41), smoking (β=0.82; 95% CI=0.66; 0.97), dry mouth (β=0.37; 95% CI=-0.65 to 0.10) functional and motor functioning (β=0.32; 95% CI=-0.45 to 0.17), DMFT (β=0.06; 95% CI=0.02; 0.09), CPI (β=0.22; 95% CI=0.04; 0.04), physical component measure of GHRQoL (β=-0.275; 95% CI=-0.42 to 0.13), lesion level at the lumbar-sacral (β=-0.18; 95% CI=-0.29 to -0.06) and thoracic level (β=-0.09; 95% CI=-0.11 to -0.06). CONCLUSION SCI patients had poor oral hygiene practices, greater levels of plaque, gingival bleeding, and caries experience than the healthy controls. In addition, more number of SCI patients had periodontal pockets and dry mouth than the comparative group. SCI patients experienced more depression and anxiety, poor GHRQoL, and OHRQoL than the healthy control group. The factors that influenced OHRQoL in SCI patients were age, toothbrushing frequency, smoking, oral clinical status, depression, physical component of GHRQoL, and level of lesion.
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Affiliation(s)
- Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, Qazvin 3419759811, Iran.
| | - Santhosh Kumar
- Population Social Health Research Program, Griffith Health Institute & School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Janneke F M Scheerman
- Academic Centre of Dentistry Amsterdam, Department of Preventive Dentistry, ACTA University, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; Oral Hygiene, Department of Health, Sports & Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Henrik Jansson
- Center for Oral Health, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden
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Smith CJ, Horne M, McCracken G, Young D, Clements I, Hulme S, Ardron C, Hamdy S, Vail A, Walls A, Tyrrell PJ. Development and feasibility testing of an oral hygiene intervention for stroke unit care. Gerodontology 2016; 34:110-120. [PMID: 27198495 DOI: 10.1111/ger.12232] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To develop an oral hygiene complex intervention and evaluate its feasibility in a single UK stroke centre. BACKGROUND Oral hygiene interventions might improve clinical outcomes after stroke but evidence-based practice is lacking. MATERIALS AND METHODS We used a sequential mixed methods approach and developed an oral hygiene complex intervention comprising: (i) web-based education and 'hands-on' practical training for stroke unit nursing staff, (ii) a pragmatic oral hygiene protocol consisting of twice-daily powered (or manual if preferred) brushing with chlorhexidine gel (or non-foaming toothpaste) ± denture care. We evaluated feasibility of (i) the staff education and training and (ii) the oral hygiene protocol in consenting inpatients with confirmed stroke, requiring assistance with at least one aspect of personal care. RESULTS The staff education and training were feasible, acceptable and raised knowledge and awareness. Several barriers to completing the education and training were identified. The oral hygiene protocol was feasible and well-tolerated. 22% of eligible patients screened declined participation in the study. Twenty-nine patients (median age = 78 year; National Institutes of Health Stroke Scale score = 8.5; 73% dentate) were recruited at a median of 7 days from stroke onset. 97% of participants chose the default chlorhexidine-based protocol; the remainder chose the non-foaming toothpaste-based protocol. The mouth hygiene protocol was administered as prescribed on 95% of occasions, over a median duration of 28 days. There were no adverse events attributed to the oral hygiene protocol. CONCLUSION Our oral hygiene complex intervention was feasible in a single UK stroke centre. Further studies to optimise patient selection, model health economics and explore efficacy are now required.
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Affiliation(s)
- Craig J Smith
- Greater Manchester Comprehensive Stroke Centre, Manchester Academic Health Science Centre, Salford Royal Foundation Trust, Salford, UK.,Stroke and Vascular Centre, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - Maria Horne
- Faculty of Health Studies, School of Nursing, University of Bradford, Bradford, UK
| | - Giles McCracken
- School of Dental Sciences, Newcastle University, Newcastle, UK
| | - David Young
- The Greater Manchester School for Dental Care Professionals (MANDCP), Salford, UK
| | - Ian Clements
- Patient, Carer and Public Involvement Group, North West Stroke Research Network, Salford Royal NHS Foundation Trust, Salford, UK
| | - Sharon Hulme
- Stroke and Vascular Centre, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - Claire Ardron
- Greater Manchester Comprehensive Stroke Centre, Manchester Academic Health Science Centre, Salford Royal Foundation Trust, Salford, UK
| | - Shaheen Hamdy
- Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Andy Vail
- Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester, UK
| | - Angus Walls
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, UK
| | - Pippa J Tyrrell
- Greater Manchester Comprehensive Stroke Centre, Manchester Academic Health Science Centre, Salford Royal Foundation Trust, Salford, UK.,Stroke and Vascular Centre, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK
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Oral health related quality of life and it’s related factors of stroke patients at home in Korea. Arch Gerontol Geriatr 2015; 61:523-8. [DOI: 10.1016/j.archger.2015.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 06/27/2015] [Accepted: 06/29/2015] [Indexed: 11/17/2022]
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Kwok C, McIntyre A, Janzen S, Mays R, Teasell R. Oral care post stroke: a scoping review. J Oral Rehabil 2014; 42:65-74. [DOI: 10.1111/joor.12229] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- C. Kwok
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - A. McIntyre
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - S. Janzen
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - R. Mays
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - R. Teasell
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry; Western University; London ON Canada
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Dai R, Lam OLT, Lo ECM, Li LSW, Wen Y, McGrath C. Orofacial functional impairments among patients following stroke: a systematic review. Oral Dis 2014; 21:836-49. [PMID: 25041135 DOI: 10.1111/odi.12274] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/11/2014] [Accepted: 06/23/2014] [Indexed: 11/27/2022]
Affiliation(s)
- R Dai
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
| | - O LT Lam
- Department of Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 4/F; Sai Ying Pun Hong Kong China
| | - E CM Lo
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
| | - L SW Li
- Department of Rehabilitation Medicine; Tung Wah Hospital; Sheung Wan Hong Kong China
| | - Y Wen
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
| | - C McGrath
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
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Dai R, Lam OLT, Lo ECM, Li LSW, Wen Y, McGrath C. A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. J Dent 2014; 43:171-80. [PMID: 24960298 DOI: 10.1016/j.jdent.2014.06.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 06/12/2014] [Accepted: 06/14/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective of this study was to review clinical, microbiological, and immunological aspects of oral health, as well as oral health related behaviours among patients following stroke. DATA SOURCES A structured search strategy was applied to three electronic databases to identify relevant papers. STUDY SELECTION The initial search yielded 19,927 papers, 60 potentially relevant studies (Kappa: 0.974) and 23 relevant papers (Kappa: 0.965) in accordance with the inclusion criteria. Outcomes regarding tooth condition, periodontal condition, oral hygiene status, and dental attendance were pooled for seven meta-analyses. Narrative summaries were provided for those outcomes which could not be pooled for meta-analysis. RESULTS The standardized differences in mean values of the parameters (fixed effect, random effect model) for patients with stroke compared to control groups were: number of teeth (-0.325, -0.271), DMFT (0.246, 0.246), oral hygiene status - plaque index (0.305, 0.356) and gingival index (0.716, 0.653), periodontal health status - clinical attachment loss (0.437, 0.490) and probing depth (0.470, 0.579). In addition, a lower chance of dental attendance was observed among patients with stroke (odds ratio: 0.493, 0.480). For those outcomes which could not be pooled for meta-analysis, it was not possible to draw any qualitative conclusion due to the equivocal results of these studies. CONCLUSIONS There is an increasing interest in oral health of patients with stroke. Patients with stroke had a poorer clinical oral health status across a range of parameters (tooth loss, dental caries experience, and periodontal status). Coupled with this, their dental attendance was less frequent. Further studies employing standardized assessments of oral health/oral health behaviour can confirm these oral health disparities. CLINICAL SIGNIFICANCE With comprehensive literature search, this systematic review and meta-analysis indicated a poorer oral health status and less frequent dental attendance behaviour among patients with stroke.
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Affiliation(s)
- Ruoxi Dai
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Otto L T Lam
- Department of Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 4/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Edward C M Lo
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Leonard S W Li
- Department of Rehabilitation Medicine, Tung Wah Hospital, 12 Po Yan Street, Sheung Wan, Hong Kong, China
| | - Yifeng Wen
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Colman McGrath
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China.
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Asahi Y, Omichi S, Ono T. Orodental status and medical problems of stroke inpatients undergoing rehabilitation at a rehabilitation hospital in Japan. Gerodontology 2014; 32:237-40. [DOI: 10.1111/ger.12059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Yoshinao Asahi
- Department of Dentistry; Morinomiya Hospital; Osaka city Osaka Japan
- Department of Dentistry; Bobath Memorial Hospital; Osaka city Osaka Japan
| | - Shiro Omichi
- Department of Dentistry; Morinomiya Hospital; Osaka city Osaka Japan
- Department of Dentistry; Bobath Memorial Hospital; Osaka city Osaka Japan
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Osaka University Graduate School of Dentistry; Suita Osaka Japan
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Oh DW, Kang TW, Kim SJ. Effect of stomatognathic alignment exercise on temporomandibular joint function and swallowing function of stroke patients with limited mouth opening. J Phys Ther Sci 2013; 25:1325-9. [PMID: 24259786 PMCID: PMC3820193 DOI: 10.1589/jpts.25.1325] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022] Open
Abstract
[Purpose] This study investigated the effects of stomatognathic alignment exercise on
temporomandibular joint function and swallowing function of stroke patients presenting
limited mouth opening. [Subjects] Fourteen subjects with post-stroke hemiparesis
presenting limited mouth opening were randomly assigned to either the experimental group
or the control group, with 7 subjects in each group. [Methods] Subjects in the
experimental group participated in a stomatognathic alignment exercise program that
consisted of mobility exercises of the TMJ and neck and postural correction. Main outcome
measures were neck mobility, the active maximum range of mouth opening, the
craniomandibular index (CMI), and the Mann assessment of swallowing ability (MASA) score.
[Results] The changes in the values of the range of mouth opening, CMI, MASA, and all the
parameters of neck mobility were significantly different between the groups. Furthermore,
post-test values appeared to be significantly different for the range of mouth opening,
the craniomandibular index, and the MASA scores between the groups (p>0.05).
[Conclusion] Stomatognathic alignment exercise may improve TMJ function and swallowing
function of patients with post-stroke hemiparesis.
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Affiliation(s)
- Duck-Won Oh
- Department of Physical Therapy, College of Health Science, Cheongju University, Republic of Korea
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Awad MA, Rashid F, Feine JS. The effect of mandibular 2-implant overdentures on oral health-related quality of life: an international multicentre study. Clin Oral Implants Res 2013; 25:46-51. [DOI: 10.1111/clr.12205] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Manal A. Awad
- Department of General & Specialist Dental Practice; College of Dentistry; University of Sharjah; Sharjah UAE
| | - Faahim Rashid
- Faculty of Dentistry; Ajman University of Science & Technology; Ajman UAE
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Lindqvist L, Seleskog B, Wårdh I, von Bültzingslöwen I. Oral care perspectives of professionals in nursing homes for the elderly. Int J Dent Hyg 2013; 11:298-305. [DOI: 10.1111/idh.12016] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2012] [Indexed: 11/30/2022]
Affiliation(s)
- L Lindqvist
- Preventive Dentistry Department; Public Dental Health; Värmland; Sweden
| | - B Seleskog
- Public Dental Health; Norrstrand Värmland; Sweden
| | - I Wårdh
- Department of Dental Medicine; Karolinska Institutet; Stockholm; Sweden
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Changes in oro-facial function and hand-grip strength during a 2-year observation period after stroke. Clin Oral Investig 2012; 17:867-76. [DOI: 10.1007/s00784-012-0769-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 06/07/2012] [Indexed: 10/28/2022]
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Katsoulis J, Schimmel M, Avrampou M, Stuck AE, Mericske-Stern R. Oral and general health status in patients treated in a dental consultation clinic of a geriatric ward in Bern, Switzerland. Gerodontology 2011; 29:e602-10. [DOI: 10.1111/j.1741-2358.2011.00529.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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