title: Oral health in older patients with oropharyngeal dysphagia.
abstract: BACKGROUND
  oropharyngeal dysphagia (OD), aspiration and poor oral health status are potential risk factors in elderly patients with aspiration pneumonia (AP).
  
  
  OBJECTIVE
  to assess the oral hygiene status and the prevalence of periodontal disease and dental caries in elderly patients with OD.
  
  
  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.
authors.affiliation: Hospital de Mataró. Universitat Autònoma de Barcelona, Unitat d'Exploracions Funcionals Digestives, Mataró, Barcelona, Spain.
authors.forename: Omar
authors.initials: O
authors.lastname: Ortega
authors.forename: Carlos
authors.initials: C
authors.lastname: Parra
authors.forename: Silvia
authors.initials: S
authors.lastname: Zarcero
authors.forename: Jose
authors.initials: J
authors.lastname: Nart
authors.forename: Olga
authors.initials: O
authors.lastname: Sakwinska
authors.forename: Pere
authors.initials: P
authors.lastname: Clavé
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003731:Dental Caries / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D005891:Gingivitis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009066:Mouth, Edentulous / Q000453:epidemiology; D009909:Oral Health; D009910:Oral Hygiene; D009911:Oral Hygiene Index; D010518:Periodontitis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011015:Pneumonia, Aspiration / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D053120:Respiratory Aspiration / Q000453:epidemiology; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014741:Video Recording
keywords: Swallowing disorders; aspiration pneumonia; elderly; older people; oral hygiene; periodontal diseases