A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke

Dai, Ruoxi; Lam, Olt; Lo, Edward Chin Man; Li, Leonard S.W.; Wen, Yi Feng; McGrath, Colman

doi:10.1016/j.jdent.2014.06.005

Cited by 71 publications

(66 citation statements)

References 45 publications

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“…Previous studies involving stroke patients also reported a significantly lower oral health‐related QOL and greater prevalence of periodontitis and tooth erosion in stroke patients than in non‐stroke patients . In a study by Dai, patients with stroke reported less frequent dental check‐ups . Thus, the finding of inferior oral hygiene practices among stroke patients in the present study was consistent with the results of previous studies.…”

Section: Discussionsupporting

confidence: 88%

“…First, an analysis of the association between the ambulation level and functional independence revealed that self‐perceived oral health was poor when the stroke patients had physical limitations or were bed‐bound, with a statistically significant difference between these patients and patients without physical limitations. As mentioned above, Dai reported that patients with stroke did not frequently receive dental check‐ups . These findings were consistent with the findings by Marino, who documented a negative correlation between the physical health‐related QOL and the subjective oral health status .…”

Section: Discussionsupporting

confidence: 86%

“…Of late, the importance of oral care in stroke patients has been emphasised, and several studies have been published . Most studies, however, evaluated the relationship between the presence of stroke and the oral health status and oral hygiene practices.…”

Section: Introductionmentioning

confidence: 87%

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Differences in the oral health status and oral hygiene practices according to the extent of post‐stroke sequelae

Kim

Park

Lee

et al. 2018

J of Oral Rehabilitation

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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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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 86%

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Differences in the oral health status and oral hygiene practices according to the extent of post‐stroke sequelae

Kim

Park

Lee

et al. 2018

J of Oral Rehabilitation

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“…However, periodontal disease and stroke share a considerable number of risk factors with the inflammatory processes associated with the former increasing risk of the latter . As the oral health status of stroke survivors was not measured before admission, this outcome could be attributed to the possibility that people who suffer a stroke have comparatively worse oral health than an equivalent group in the community …”

Section: Discussionmentioning

confidence: 99%

Oral flora in acute stroke patients: A prospective exploratory observational study

et al. 2017

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“…An often neglected aspect of stroke treatment is oral care. Poor oral hygiene leads to proliferation of bacteria and debris in the oral cavity [52], which are liable to be aspirated causing respiratory tract infection [53]. This is particularly important in nasogastric tube fed patients in whom oral care can easily be missed.…”

Section: Causes Of Hypoxia In Acute Strokementioning

confidence: 99%

Hypoxia after stroke: a review of experimental and clinical evidence

Ferdinand

Roffe

2016

Exp & Trans Stroke Med

100

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BackgroundHypoxia is a common occurrence following stroke and associated with poor clinical and functional outcomes. Normal oxygen physiology is a finely controlled mechanism from the oxygenation of haemoglobin in the pulmonary capillaries to its dissociation and delivery in the tissues. In no organ is this process more important than the brain, which has a number of vascular adaptions to be able to cope with a certain threshold of hypoxia, beyond which further disruption of oxygen delivery potentially leads to devastating consequences. Hypoxia following stroke is common and is often attributed to pneumonia, aspiration and respiratory muscle dysfunction, with sleep apnoea syndromes, pulmonary embolism and cardiac failure being less common but important treatable causes. As well as treating the underlying cause, oxygen therapy is a vital element to correcting hypoxia, but excessive use can itself cause molecular and clinical harm. As cerebral vascular occlusion completely obliterates oxygen delivery to its target tissue, the use of supplemental oxygen, even when not hypoxic, would seem a reasonable solution to try and correct this deficit, but to date randomised clinical trials have not shown benefit.ConclusionWhilst evidence for the use of supplemental oxygen therapy is currently lacking, it is vital to rapidly identify and treat all causes of hypoxia in the acute stroke patient, as a failure to will lead to poorer clinical outcomes. The full results of a large randomised trial looking at the use of supplemental oxygen therapy are currently pending.

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A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke

Cited by 71 publications

References 45 publications

Differences in the oral health status and oral hygiene practices according to the extent of post‐stroke sequelae

Differences in the oral health status and oral hygiene practices according to the extent of post‐stroke sequelae

Oral flora in acute stroke patients: A prospective exploratory observational study

Hypoxia after stroke: a review of experimental and clinical evidence

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