Predictors of oral health after spinal cord injury

Abstract

Study design: Cross-sectional study. Objectives: To examine predictors of oral health in people with spinal cord injury (SCI). Methods: Ninety-two people with SCI (X6 months, 44% cervical level) completed questionnaires and underwent oral examination. Socio-economic, injury-related and oral habits variables were used for predicting Oral Health Score (OHS); Decayed, Missing and Filled Teeth (DMFT) score; and Periodontal Screen and Recording Index (PSR). Results: Most people with SCI were able to bring at least one hand to the mouth (82%) and brush teeth independently (65%). Regarding daily oral habits, 84% reported brushing teeth, 48% rinsing mouth, 14% flossing, 33% tobacco use and 13% mouthstick use. Only 32% had teeth cleaned within the past year. Oral examination revealed three decayed and eight missing teeth on average, with prominent periodontal disease (64%). Employment before SCI and more risky oral habits were significant predictors of worse OHS (P ¼ 0.005 and P ¼ 0.014, respectively) and PSR score (P ¼ 0.010 and P ¼ 0.035, respectively). Older age was the only predictor of worse DMFT score (Po0.001). Conclusion: Oral health appears compromised in people with SCI. Identification of modifiable risk factors warrants examination whether intervention with focus on behavioral changes may improve oral health in this population.

Treatment Plan and Challenges in Full‐Mouth Rehabilitation of a Quadriplegic Patient: A Clinical Report

“…Thus, it was a compromise between the patient's wish and the implementation of oral hygiene measures. 27 Dependency on caregivers for daily oral care may be an important determinant of oral health; dependent persons with SCI tend to have poorer oral hygiene, have more plaque, and more commonly have severe gingivitis and periodontal disease than independent persons. 28,29 Figure 3 indicated that the patient still has a lot of plaque in the anterior area.…”

“…Even though the caregivers were instructed regarding the oral hygiene measures the outcome needed improvement. 27 Furthermore, the medications necessary to reduce muscle tone and the frequency of muscle spasms or neurogenic bladder disorders in individuals with SCI can cause an increased accumulation of dental plaque and dental caries because of xerostomia. 30 Resulting dental diseases can not only cause physical and functional complaints but also lead to negative effects in the social, psychological and economic sectors.…”