Comprehensive oral-health assessment of individuals with acquired brain-injury in neuro-rehabilitation setting

Abstract

Primary objective: To perform a detailed clinical oral health assessment and oral-health-related social and behavioural aspect assessment in individuals with acquired brain injury (ABI).

Research design: Prospective observational study.

Methods and procedures: Thirteen individuals with ABI were recruited. Individual’s social and behavioural history, bed-side oral examination score (BOE), tooth condition and periodontal status (bleeding, plaque and clinical attachment loss) were thoroughly examined. The entire examination took up to 60 minutes, using proper dental armamentarium.

Main outcomes and results: All evaluated individuals were diagnosed with chronic generalized periodontitis. A relationship between active periodontal disease and severe BOE score was observed (p = 0.01). Significant interaction between severe BOE scores (≥ 15 or ≥ 14) and periodontal disease severity of ≥ 2 mm (p = 0.01) was observed. The same interaction was seen between severe BOE scores and the combination of 75% extent and 2 mm severity (p = 0.01). Severity and activity of periodontitis showed dependence on individual brushing frequency (p = 0.03 and p = 0.05, respectively).

Conclusions: Individuals with ABI had a poor status across a range of oral-, dental- and periodontal-related parameters. Further structured studies are required to define evidence-based assessment approaches for such clinical reality.

Keywords:

• Acquired brain injury
• oral health
• oral hygiene
• periodontal status
• systemic diseases
• periodontitis

Acknowledgement

The authors would like to thank the staff at Early Intensive Care Unit, Hammel Neurorehabilitation Centre and University Research Clinic, in particular the Occupational Therapy staff who were integral in potential participant identification and also assisted as a recorder during the clinical examination. A special thanks to Ellen Frandsen Lau, Associate Professor, Institute of Odontology and Oral Health for encouragement and providing dental instruments for the study, and to all the study participants who gave of their time generously.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This research was partially funded by Region Midtjylland, Denmark.