Oral health in older patients with oropharyngeal dysphagia

Omar Ortega, Carlos Parra, Silvia Zarcero, Jose Nart, Olga Sakwinska, Pere Clavé

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Abstract

Background: oropharyngeal dysphagia (OD), aspiration and poor oral health status are potential risk factors in elderly patients with aspiration pneumonia (AP). Aim: to assess the oral hygiene status and the prevalence of periodontal disease and dental caries in elderly patients with OD. Patients and methods: fifty elderly patients (79.7 ± 6.64 years) with OD associated with ageing or neurological diseases and 15 elderly patients without OD (77.01 ± 4.51 years) were enrolled in this observational-transversal study. OD and aspiration were evaluated by videofluoroscopy (VFS). Oral health was assessed by: (i) the Simplified Oral Hygiene Index (OHI-S); (ii) a complete periodontal examination, assessing the periodontal pocket depth, clinical attachment loss and bleeding on probing to study periodontal diseases (periodontitis, gingivitis); and (iii) the presence of dental caries. Results: 8/50 elderly patients with OD presented VFS signs of aspiration, half of them silent; 40/50, signs of penetration into laryngeal vestibule and 16/50, oropharyngeal residue. Prevalence of edentulism and caries was higher in patients with OD. Dentate older patients with OD (30/50) presented the following complications (i) poor oral hygiene in 18 patients (OHI-S 3.1-6), (ii) gingivitis in 2 and periodontitis in 28 and (iii) caries in 16. Conclusions: older patients with OD presented polymorbidity and impaired health status, high prevalence of VFS signs of impaired safety of swallow and poor oral health status with high prevalence of periodontal diseases and caries. These patients are at great risk of developing AP. We recommend a policy of systematic oral health assessment in elderly patients with OD. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
Original languageEnglish
Article numberaft164
Pages (from-to)132-137
JournalAge and Ageing
Volume43
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Aspiration pneumonia
  • Elderly
  • Older people
  • Oral hygiene
  • Periodontal diseases
  • Swallowing disorders

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    Ortega, O., Parra, C., Zarcero, S., Nart, J., Sakwinska, O., & Clavé, P. (2014). Oral health in older patients with oropharyngeal dysphagia. Age and Ageing, 43(1), 132-137. [aft164]. https://doi.org/10.1093/ageing/aft164