The Effects of Stroke on Oral Function and Oral Health: A Qualitative Study.

Older adults with serious illness are particularly vulnerable to oral disease due to worsened overall health, progressive functional loss and polypharmacy. Meanwhile, inability to communicate oral health needs, increased functional disability and psychological distress also hamper timely oral health care and lead to prolonged suffering and compromised quality of life. While many seriously-ill older adults with poor oral health receive no oral health care prior to death, unnecessary treatment is also common. In response to these issues, a new oral health care model is proposed to better address the oral health needs of older adults with serious illness. This model aims to promote comfort, maintain oral function and improve quality of life. End-of-life oral health trajectories and stage-appropriate oral health care strategies are also introduced to guide the care of these vulnerable individuals.

Poor oral health can influence an individual's dietary intake, which may result in malnutrition. Both problems in oral health and function and malnutrition are common in older people. The aim of the present study was to explore the associations between oral health and oral function and malnutrition in community-dwelling older people within three different databases. Data analyses were performed on three existing Dutch databases (Interrai: n = 3876, LPZ: n = 966, PRIMa mouth CARE: n = 975). Logistic regressions (adjusted for age and gender) tested the relation between oral health and oral function (independent variable) and malnutrition (dependent variable). Problems in oral health and oral function such as broken teeth (OR: 1.43 [95%CI: 1.12-1.81]), oral pain and discomfort (OR: 2.58 [95%CI: 1.52-4.39]), chewing difficulties (OR: 1.99 [95%CI: 1.54-2.57]), swallowing problems (OR: 6.63 [95%CI: 2.85-15.42]), coughing (OR: 6.05 [95%CI: 2.08-17.61]) and food adaptations (OR: 5.46 [95%CI: 2.60-11.4]) were found to be significantly associated with malnutrition in older people. This study demonstrated a significant link between oral health problems and oral function with malnutrition in community-dwelling older people. Oral health care and healthcare professionals need to consider oral health and oral function in relation to nutritional status and vice versa in community-dwelling older people.

ABSTRACTObjectivesPerioperative oral health care traditionally focuses on oral hygiene to prevent post‐surgical infection, with limited attention to oral function. This study explores perioperative changes in oral function in association with oral food intake in patients receiving gastric or oesophageal cancer surgery.MethodsPatients who underwent surgery for gastric or oesophageal cancer at a university hospital and visited its outpatient dental centre for perioperative oral health care were recruited from August 2018 to March 2021. Several oral function parameters (lip‐tongue motor function, tongue pressure, occlusal force, oral dryness and dysphagia score) were measured 1 day before and 7 days after treatment. The patients were categorised into the oral intake (PO) and non‐oral intake (NPO) groups based on oral food intake status at 7 days post‐surgery, and perioperative changes in oral function were analysed using the Wilcoxon signed‐rank test between the PO and NPO groups for both gastric and oesophageal cancers.ResultsOf the 298 gastric cancer patients and 71 oesophageal cancer patients analysed, 87% and 24% of patients, respectively, were capable of oral food intake at 7 days after surgery. In gastric cancer patients, oral hygiene, tongue pressure and dysphagia scores significantly worsened in the PO group. In contrast, oral hygiene, tongue pressure and dysphagia scores were all significantly worsened in the oesophageal cancer NPO group, but not in the PO group. Oral dryness and occlusal force did not change remarkably regardless of oral food intake status in these patients.ConclusionsThis study uncovered a significant decrease in oral function in oesophageal cancer patients without postoperative oral food intake, suggesting a potential association between impaired oral motor function and delayed oral intake recovery. Accordingly, perioperative oral function management alongside oral hygiene care is advisable for early resumption of oral food intake.

REVIEW QUESTION/OBJECTIVE The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia. More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. INCLUSION CRITERIA Types of participants This review will consider studies that include residents with a formal diagnosis of dementia currently residing in permanent care in Residential Aged Care Facilities. This review will exclude participants that have not received a formal diagnosis of dementia as well as those who are not living as a permanent admission in Residential Aged Care Facilities. Studies conducted on community dwelling individuals with a formal diagnosis of dementia will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the efficacy of professional oral health care performed by a dental hygienist. These studies involve professional oral health care performed by a dental hygienist using a toothbrush, interdental brushes, floss and hand scalers if necessary to remove plaque and food debris and in some instances hardened calculus or tartar. If there are studies involving the professional oral health care being performed by dentists or a combination of dentists and dental hygienists they will be included in the analysis. This review will exclude interventions involving staff training interventions and interventions performed by nurses/assistant nurses. TRUNCATED AT 250 WORDS

Oral health is an often-undervalued contributor to overall health. The literature, however, underscores the myriad of systemic diseases influenced by oral health, including type II diabetes, heart disease, and atherosclerosis. Thus, assessments of oral health, called oral screenings, have a significant role in assessing risk of disease, managing disease, and even improving disease by oral care. Here we present a method to assess oral health quickly and consistently across time. The protocol is simple enough for non-oral health professionals such as students, family, and caregivers. Useful for any age of patient, the method is particularly key for older individuals who are often at risk of inflammation and chronic disease. Components of the method include existing oral health assessment scales and inventories, which are combined to produce a comprehensive assessment of oral health. Thus, oral characteristics assessed include intraoral and extraoral structures, soft and hard tissues, natural and artificial teeth, plaque, oral functions such as swallowing, and the impact this oral health status has on the patient's quality of life. Advantages of this method include its inclusion of measures and perceptions of both the observer and patient, and its ability to track changes in oral health over time. Results acquired are quantitative totals of questionnaire and oral screening items, which can be summed for an oral health status score. The scores of successive oral screenings can be used to track the progression of oral health across time and guide recommendations for both oral and overall health care.

Purpose Activities of daily living including oral care may be challenging after stroke. Some stroke survivors are not able to complete oral care independently and need assistance from healthcare professionals and care partners. Poor oral hygiene may impact stroke recovery and rehabilitation possibly incurring issues such as aspiration pneumonia, malnutrition, and social isolation. The objective of this paper is to outline practical ways to apply oral care technology in daily use for stroke survivors. Materials and methods We reviewed the literature on i) stroke-related impairments impacting oral care, ii) oral hygiene dental devices, and iii) technology for oral care education. Results Oral care activities involve integrated skills in the areas of motivation, energy, planning, body movement and sensation, and mental acuity and health. Post-stroke impairments such as fatigue, hemiparesis, and mental impairments may impact oral care activities. Technology may help survivors and caregivers overcome some barriers. Three types of technologies are available for facilitating post-stroke oral care: i) non-powered tools and adaptations; ii) powered oral care tools, and; iii) electronic aids to guide oral care activities. Particular choices should maximise patient safety and autonomy while ensuring accessibility and comfort during oral care tasks. Conclusion The available device and technologies may help substantially with the accommodations needed for post-stroke oral care, improving the oral health of stroke survivors. Good oral health confers benefit to overall health and well-being and could enhance recovery and rehabilitation outcomes. Nonetheless, more research is necessary to demonstrate the feasibility and effectiveness of technology in stroke contexts. IMPLICATIONS FOR REHABILITATION Oral care may be challenging after stroke due to patient fatigue, hemiparesis, cognitive impairments, and other impaired body functions. Poor oral hygiene may impact stroke recovery and rehabilitation due to risk of aspiration pneumonia, malnutrition, and social isolation. Powered oral care tools, non-powered tools, and adaptations to non-powered tools are some of the technology available to help overcome post-stroke barriers for oral care. Computer programs and online resources for education and guidance for oral care activities may help improve recommendation uptake and compliance.

Substance use disorders negatively impact oral health, but there is limited data on their relationship with oral function, overall health, and quality of life in affected individuals. To assess the oral health-related quality of life (OHRQoL) and quality of life among substance users and explore the influence of oral health status, function, and dental care access on these outcomes. This cross-sectional study collected data from 42 participants from a rehabilitation center via a structured online questionnaire using validated and reliable tools that assessed oral hygiene, smoking, alcohol use, oral and general health, quality of life, OHRQoL, and access to dental services. The 42 participants exhibited moderate impairment in oral health-related quality of life. Missing teeth, financial barriers, and poor access to dental care were associated with worse oral health outcomes (p < 0.05). Oral functioning strongly influenced both OHRQoL and overall health (p < 0.05). There is a critical need for integrated, patient-centered oral healthcare programs within addiction rehabilitation settings to enhance treatment effectiveness and quality of life for this underserved population.

Spending time away from bed is important in older adults. Not doing so can lead to functional decline rapidly. To investigate the association between oral function and time spent away from bed in older adults living in nursing homes. We enrolled 748 adults aged ≥65 years across eight nursing homes between April 2022 and March 2023. 'Problems with oral hygiene' and 'problems with oral function' were the dependent variables in the multiple regression analyses to determine their association with time spent away from bed. We selected 304 participants (76 men; mean age, 86.3 ± 7.5 years) and divided them into three groups: group S (< 4 h), group M (4 to < 6 h) and group L (≥ 6 h), with 28, 23 and 253 participants, respectively. Comparison of the characteristics between the groups demonstrated significant differences in the Barthel index (p < .001), time spent away from bed (p < .001), history of aspiration pneumonia (p < .001), confirmation of meals and food forms (p = .010), problems with oral hygiene (p = .014), and problems with oral function (p = .002). Based on multiple regression analyses, 'problems with oral hygiene' (p < .001) and 'problems with oral function' (p < .001) were significantly associated with time spent away from bed. The time spent away from bed was significantly associated with both oral hygiene and function in older adults, suggesting the importance of extending the time that older adults spend away from bed.

This chapter will describe the role and evolution of the scope of clinical practice of dental hygienists, dental therapists and oral health therapists. These three groups of allied oral health professionals are playing an increasingly important role in the provision of oral health services and it is therefore important to understand how they are utilised as part of the dental team. Historically, the dental hygiene profession originated in the early 1900s in the US, followed by Norway, 1924; United Kingdom, 1943; Canada, 1947; Japan, 1948; and Australia, 1971 (Johnson, 2009). Dental hygienists predominantly provide health education, preventive, periodontal and orthodontic auxiliary services to people of all ages. Dental therapists were introduced in New Zealand in 1921 to provide basic preventive and restorative dental care for children in the School Dental Service. Currently more than 50 countries utilise dental therapists (Nash et al., 2008). In Australia and New Zealand, dental therapists have been responsible for examining, diagnosing, and developing plans for the oral health treatment they provide to children and adolescents, and referring patients with treatment needs beyond their scope of practice to dentists (Satur et al., 2009). Oral health therapists are a relatively new addition to the dental team. They have the combined education and training of both a dental therapist and a dental hygienist. Currently across Australia all oral health therapy education is provided through the tertiary education sector. An emerging oral health problem in many Western countries is access to dental services by disadvantaged groups, in particular public adult dental patients. Oral health disparities and socioeconomic disadvantage have led to a growing burden of disease amongst sections of the community who at the same time have difficulties accessing appropriate oral health services. There is currently debate in the United States and elsewhere about the need for an oral health practitioner with similar skills to a dental therapist to address the high levels of unmet restorative treatment needs and extend access to oral health care services for lower income groups. This is somewhat different to the situation in countries like Australia, where dental therapists have been long accepted as playing a role in the provision of oral health

Gap in Dental Care Can Lead to Diabetes, Other Disease Conditions

This study aimed to assess oral hygiene practices, dental conditions, and access to dental care among children with autism spectrum disorder (ASD) in Tunisia. This descriptive cross-sectional study included 48 children diagnosed with ASD. Data were obtained through a structured questionnaire completed by caregivers and a clinical oral examination. The questionnaire comprised 25 items divided into three domains: (1) Knowledge (awareness of oral hygiene importance, fluoride use, recognition of dental caries, and regular dental checkups); (2) Attitude (motivation for oral care, caregiver perception of dental visits, and beliefs about prevention); (3) Practices (tooth brushing frequency, technique, use of toothpaste, dental attendance, and dietary habits). The clinical examination assessed oral hygiene status, presence of untreated caries, gingival condition, and parafunctional oral habits. Descriptive statistics were used to analyze the data. Of the 48 children included in the study, 23% (n = 11) were classified at the severe end of the autism spectrum, while the remaining 77% (n = 37) presented with mild to moderate forms of ASD. Poor oral hygiene was observed in 46.6% (n = 14) of the children, untreated dental caries were present in 36.6% (n = 11), and 60% (n = 18) had never visited a dentist. Additionally, 33.3% (n = 10) of the children did not brush their teeth regularly. The presence of gingival inflammation and parafunctional habits was also noted but varied across severity levels of ASD. The study reveals considerable challenges regarding oral hygiene behaviors, dental health status, and access to dental care among children with ASD in Tunisia. These findings underscore the necessity for targeted oral health education programs and enhanced caregiver involvement to improve oral health outcomes in this population. A better understanding of the specific oral health needs of children with ASD is essential for tailoring dental care protocols. Focused caregiver training and adapted dental approaches are recommended to promote improved oral hygiene practices and overall oral health in children with ASD. How to cite this article: Ben Hadj Khalfa A, Boukhris H, Ayari G, et al. Oral Health Challenges and Hygiene Practices in Children with Autism Spectrum Disorder: A Cross-sectional Study from Tunisia. J Contemp Dent Pract 2025;26(6):581-586.

Objectives: To develop a program that combines the oral health promotion program for the elderly and to investigate the effect of improving oral function by applying the oral health promotion program to elderly people using welfare facilities. Methods: From June to October 2022, a total of 29 elderly individuals utilizing welfare facilities in the Gyeongnam region were recruited. The control group underwent surveys and objective oral health assessments. The experimental group participated in an oral health promotion program, consisting of oral functional rehabilitation exercises and expert oral health management, conducted once a week for 8 weeks at the facilities. Objective oral health assessments were conducted before, during (at 4 weeks), and after (at 8 weeks) the intervention period for both groups. Results: As a result of the oral health promotion program, it was confirmed that there was an improvement effect in bad breath (p&lt;0.001), saliva secretion amount (p&lt;0.001), orbicularis oculi muscle (p&lt;0.001), and plaque index (p&lt;0.001). Conclusions: A revitalization plan is needed so that the efficient oral health promotion program for the elderly can be reflected as a systematic and professional community care oral health management program.

The purpose of this research was to analyse the relationship between oral health status, oral motor function, daily life situations and self-assessed oral health. A cross-sectional survey was conducted on 190 independent elderly volunteers aged 62-99 years from senior citizen centres in Tokyo, Japan. A questionnaire survey and oral examination were conducted on each participant. For the descriptive analyses, Independent t-test and the chi-squared test were used. Following that, using four latent variables, (oral health, oral function, daily life situations and chronic health condition), a structural equation modelling analysis (SEMA) was undertaken. In the descriptive analyses, there were no significant differences between self-assessed oral health and oral health status. However, there were significant differences between self-assessed oral health and oral function and daily life situations. Findings from SEMA revealed that daily life situations and oral function have independent effects on self-assessed oral health and that the relationship between self-assessed oral health and oral health status was weak. Many factors affect self-assessed oral health status. Dental clinicians and researchers should attempt to understand these factors and incorporate them into effective personal and population-based oral health education and oral health promotion programmes.

BackgroundThe link between oral bacteria and respiratory infections is well documented. Dental plaque has the potential to be colonized by respiratory pathogens and this, together with microaspiration of oral bacteria, can lead to pneumonia particularly in the elderly and critically ill. The provision of adequate oral care is therefore essential for the maintenance of good oral health and the prevention of respiratory complications.Main bodyNumerous oral care practices are utilised for intubated patients, with a clear lack of consensus on the best approach for oral care. This narrative review aims to explore the oral-lung connection and discuss in detail current oral care practices to identify shortcomings and offer suggestions for future research. The importance of adequate oral care has been recognised in guideline interventions for the prevention of pneumonia, but practices differ and controversy exists particularly regarding the use of chlorhexidine. The oral health assessment is also an important but often overlooked element of oral care that needs to be considered. Oral care plans should ideally be implemented on the basis of an individual oral health assessment. An oral health assessment prior to provision of oral care should identify patient needs and facilitate targeted oral care interventions.ConclusionOral health is an important consideration in the management of the critically ill. Studies have suggested benefit in the reduction of respiratory complication such as Ventilator Associated Pneumonia associated with effective oral health care practices. However, at present there is no consensus as to the best way of providing optimal oral health care in the critically ill. Further research is needed to standardise oral health assessment and care practices to enable development of evidenced based personalised oral care for the critically ill.

The increases in the proportion of older persons have implications for health services. Advances in oral health care and treatment results in a reduced number of edentulous people. So have the need for care in preventive and curative oral health. Oral health in elders is important in aspects of general health and social environment. Several studies indicate that poor oral hygiene increases the risk of systemic diseases. Preventive treatment is then the most important tool to decrease the need for oral treatment and acquire a life with more dignity .The limitation on oral function is one of the factors that can restrict the selection of food and nutrition of the elderly. The results of numerous studies indicate that oral care has a low priority in the activities of daily living and there is a lack of routine oral care. So as a general objective we have to improve and maintain oral health of elders, establishing effective guidelines in the daily care of oral health by implementing Gerontagogic workshops in Oral Health. To promote an oral health policy where assistants of the centers have access to information that allows them to form in oral health care for elders, so that they can implement daily oral revisions at the centers