title: A preliminary investigation into tooth care, dental attendance and oral health related quality of life in adult stroke survivors in Tayside, Scotland.
abstract: OBJECTIVE
  The aim of this study was to investigate patterns of oral care, dental attendance and oral health-related quality of life among adults who had suffered a stroke.
  
  
  BACKGROUND
  Stroke is the most common cause of adult disability in the UK. Seventy per cent of strokes occur in adults over 65 years of age. A mild stroke may leave little residual disability but in cases of moderate or severe stroke the disability may be significant and may impact on oral health and function.
  
  
  METHODS
  A cross-sectional survey was conducted among adults surviving 1 year after stroke, between January and July 2001. A medical screening was carried out which included an assessment of disability and handicap using the modified Rankin scale. A structured interview was conducted to identify normal patterns of oral care and dental attendance and to elicit if since suffering a stroke any changes had occurred or were likely to occur. The Short Form Oral Health Impact Profile (OHIP-14) was administered prior to an oral examination. Analysis used SPSS 11.0 for Windows. Parametric and nonparametric tests were undertaken (t-tests and chi-squared tests with Yates correction where appropriate).
  
  
  RESULTS
  Forty-one adults were recruited into the study comprising 21 female and 20 male. They ranged in age from 50 to 87 years and the mean age was 69 years (SD = 9.8). Forty per cent of participants experienced moderate disability or greater following their stroke. Thirty-seven per cent had difficulty with tooth cleaning. The most frequently reported problem was being unable to use one hand properly as a result of the stroke. There was a significant association between the degree of disability following stroke and difficulty with tooth cleaning (P = 0.015). Disability as a result of the stroke was cited as the main reason for reported or projected attendance pattern change. The most frequently experienced OHIP-14 dimension was functional limitation (39%).
  
  
  CONCLUSIONS
  Individuals who have been left disabled after a stroke may require help with or advice on oral care and information on how to access dental services in a setting appropriate to their disability. Further research is needed to identify the dental needs of adults with stroke and to identify appropriate interventions to meet these needs.
authors.affiliation: Unit of Restorative Dental Care and Clinical Dental Services, The Dental School, University of Dundee, Dundee DD1 4HN, Scotland. r.v.hunter@dundee.ac.uk
authors.forename: Romana V
authors.initials: RV
authors.lastname: Hunter
authors.forename: Jan E
authors.initials: JE
authors.lastname: Clarkson
authors.forename: Hazel W
authors.initials: HW
authors.lastname: Fraser
authors.forename: Ronald S
authors.initials: RS
authors.lastname: MacWalter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003730:Dental Care for Persons with Disabilities / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009909:Oral Health; D011788:Quality of Life; D012606:Scotland; D020521:Stroke / Q000150:complications*; D017741:Survivors