Alessandro de Sire1,2, Marco Invernizzi1,3, Martina Ferrillo4, Francesca Gimigliano5, Alessio Baricich1,3, Carlo Cisari1,3, Fabiola De Marchi6, Pier Luigi Foglio Bonda7, Letizia Mazzini6, Mario Migliario7. 1. Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy. 2. Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy. 3. Physical and Rehabilitation Medicine Unit, University Hospital "Maggiore della Caritá", Novara, Italy. 4. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy. 5. Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Napoli, Italy. 6. ALS Center, Neurology Unit, University Hospital "Maggiore della Caritá", Novara, Italy. 7. Dental Clinic, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
Abstract
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p < 0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.
BACKGROUND:Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p < 0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.
Authors: Alessandro de Sire; Martina Ferrillo; Lorenzo Lippi; Francesco Agostini; Roberto de Sire; Paola Emilia Ferrara; Giuseppe Raguso; Sergio Riso; Andrea Roccuzzo; Gianpaolo Ronconi; Marco Invernizzi; Mario Migliario Journal: Nutrients Date: 2022-02-25 Impact factor: 5.717
Authors: S Silviya; Anitha C M; P S G Prakash; Sarah Ahmed Bahammam; Maha A Bahammam; Ammar Almarghlani; Mohammad Assaggaf; Mona Awad Kamil; Sangeetha Subramanian; Thodur Madapusi Balaji; Shankargouda Patil Journal: Healthcare (Basel) Date: 2022-07-13