Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study

NeuroRehabilitation. 2021;48(1):49-57. doi: 10.3233/NRE-201537.

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.

Keywords: Amyotrophic lateral sclerosis; functioning; oral hygiene; oral rehabilitation; rehabilitation.

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / diagnosis
  • Amyotrophic Lateral Sclerosis / physiopathology*
  • Cross-Sectional Studies
  • Disease Progression*
  • Female
  • Functional Status*
  • Humans
  • Male
  • Middle Aged
  • Oral Health / trends*
  • Upper Extremity / physiopathology