The appearance of primitive reflexes appears to be associated with the risk of malnutrition and developing aspiration pneumonia.
To determine whether occlusal maintenance and reconstruction by dental intervention is associated with the prognosis of older home-care patients. Methods:The study participants were 289 older home-care patients (101 males, mean age 82.2 AE 7.7 years) who received visiting dental treatment from dental clinics in the region between 2012 and 2018. The participants were followed up for 1000 days after receiving the necessary dental treatment in a home-visit setting. The participants were divided into three groups: those with natural tooth occlusion, those whose molar occlusion was maintained or reconstructed by dentures, and those whose occlusion was not reconstructed. Factors associated with prognosis were determined using the Cox proportional hazard model, with occlusal status, comorbidities, the activity of daily living, and residence status as explanatory variables.Results: In the overall population, occlusal status (hazard ratio [HR] of those with occlusal disintegration versus those with natural tooth occlusion: 2.1, confidence interval [95% CI]: 1.18-3.82) and age (HR: 2.28, 95% CI: 1.44-3.61) were identified as significant factors. In the group of participants aged <85 years, only occlusal status (HR of those with occlusal disintegration versus those with natural tooth occlusion: 3.4, 95% CI: 1.34-8.68) was a significant factor. In the group of participants aged ≥85 years, occlusal status was not significantly associated with prognosis. Conclusions:The maintenance and acquisition of occlusal support achieved by dental treatment contribute to improved prognosis in older patients younger than 85 years requiring home nursing care.
This study was conducted to clarify the actual status of oral symptoms related to the systemic and eating/swallowing functions, and the effect of ageing for those conditions in patients with Rett syndrome. The subjects were 38 females aged from 4 to 63 years diagnosed with Rett syndrome. The examination items were age, nutritional status, gross motor functions, history of epileptic seizures, antiepileptic drugs use, history of pneumonia, respiratory status (apnea, hyperventilation, and aerophagia), ingested food type, eating/swallowing functions, dysphagia symptom, occlusal condition, eating independence level, palate shape, and bruxism. Using Pearson's correlation coefficient, no significant correlation between age and nutritional status was observed (Rohrer index: p=0.12, BMI: p=0.22). When the other inter-item relationships were evaluated by the x square test and Fisher's exact test, a significant correlation was recognized between gross motor functions and oral functions (p < 0.01 ), between gross motor functions and swallowing function (p < 0.05), and between respiratory status and oral functions (p < 0.05). The investigation of the characteristics of patients with Rett syndrome suggested that decreased gross motor functions, such as gait function, and the appearance of respiratory status might herald the development of eating/swallowing dysfunction.
We performed a retrospective cohort study using medical records of 374 pediatric patients who visited a university dental clinic specializing in dysphagia rehabilitation in Japan between 2019 and 2020 to clarify the usefulness of telemedicine among disabled children receiving feeding therapy. The primary outcome was the feeding developmental stage confirmed at the final evaluation. Propensity score matching was performed between individuals in two treatment groups (in-person and telemedicine) before the final analysis using patients’ age, sex, primary disease, gross motor function, and feeding developmental stage as covariates. A total of 36 patients were enrolled in each of the in-person and telemedicine groups. The initial evaluation for the propensity score matched population using the χ2 test showed no significant difference between the two groups in any parameter. The feeding developmental stage evaluated at the final evaluation using the Wilcoxon signed-rank test significantly improved compared with the stage at the initial evaluation in both groups (in-parson group, p = 0.007; telemedicine group, p = 0.013). The difference in level achieved at the final evaluation revealed that the most common level was “unchanged,” followed by “improvement by one level” in both groups, indicating that there was no significant difference in the efficacy of feeding therapy between the two groups (p = 0.314). Our results show that telemedicine can achieve the same therapeutic outcomes as in-person therapy to improve feeding function in children with disabilities when receiving feeding therapy.
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