Orofacial function and monitoring of oral care in amyotrophic lateral sclerosis

Abstract

Objective: The aim was to assess orofacial function and monitor oral care in patients with amyotrophic lateral sclerosis (ALS) to maintain oral comfort and oral health.

Materials and methods: A case series of 14 patients newly diagnosed with ALS accepted to participate in a quality improvement project. After initial examinations, baseline oral conditions were obtained and the patients were seen every 3 months. Nordic Orofacial Test-Screening (NOT-S) was used for evaluation of orofacial function.

Results: Patients were grouped according to initial symptoms in a bulbar group and a spinal group with eight and six patients, respectively. The mean age at diagnosis was 62.8 years. All were dentate with a mean of 26.7 natural teeth. Most patients had very good oral and dental conditions. As expected, orofacial functions were differently affected in the two groups; at initial NOT-S registration, the mean total score was 5.6 (range 3–8 domains) in the bulbar group and 0.7 (0–2 domains) in the spinal group. At final registration, the corresponding figures were 6.1 and 3.2. Oral and dental aids were introduced according to need.

Conclusions: In the bulbar group, several orofacial functions became impaired at an early stage of disease development, and at final registrations many vital orofacial functions were severely compromised. The spinal group was less severely affected orally. However, all individuals irrespective of type of initial symptoms needed assistance in performing oral hygiene measures in the latter part of the disease period. Good oral health and oral comfort could be maintained in all participants and no other dental treatment was needed.

Keywords:

• Amyotrophic lateral sclerosis
• NOT-S
• oral care
• orofacial function

Acknowledgements

We sincerely thank the patients who participated in the study and their families. The project was initiated in memory of Ulla Carin Lindquist, founder of the Ulla Carin Lindqvist Foundation for ALS research. The valuable contribution of the team members dental hygienist Ann-Cathrin Widal, coordinator Annica Krogell and dietician Elisabet Allheim is gratefully acknowledged.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Birgitta Bergendal, is a specialist in prosthetic dentistry and former head of the National Oral Disability Centre for Rare Disorders at the Institute for Postgraduate Dental Education in Jönköping, Sweden. She initiated the study, performed the clinical registrations, and wrote the original draft of the manuscript. She worked on analysis of data and the final version of the manuscript.

Anita McAllister, is a speech and language pathologist employed as associate professor at CLINTEC, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. She worked on analysis of data, contributed to the draft, and the final version of the article.