Improvement of oral function and its impact on oral food intake in subacute stroke patients: A prospective study with dental intervention

Yu Sekimoto; Koichiro Matsuo; Ayu Sakai; Seiko Shibata; Shunsuke Minakuchi

doi:10.1111/joor.13711

Improvement of oral function and its impact on oral food intake in subacute stroke patients: A prospective study with dental intervention

J Oral Rehabil. 2024 Apr 23. doi: 10.1111/joor.13711. Online ahead of print.

Authors

Yu Sekimoto^{1

2

3}, Koichiro Matsuo⁴, Ayu Sakai⁵, Seiko Shibata⁶, Shunsuke Minakuchi¹

Affiliations

¹ Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
² Department of Dentistry, PL General Hospital, Medical Corporation Hosho, Tokyo, Japan.
³ Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.
⁴ Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
⁵ Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital, Toyoake, Japan.
⁶ Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.

PMID: 38651211
DOI: 10.1111/joor.13711

Abstract

Background: The association between oral food intake and oral function during the subacute stage of stroke is not well known.

Objective: To investigate (1) oral function changes in subacute stroke patients and (2) association between oral function and oral intake status at several time points.

Methods: In a prospective study involving 324 stroke patients at a convalescent rehabilitation unit, four oral function parameters (maximum tongue pressure, MTP; lip-tongue motor function, LTMF; maximum occlusal force, MOF and oral health assessment tool, OHAT) were quantitatively measured upon admission (T0), at 1 month (T1) and 2 months (T2). Oral feeding status was assessed using the Functional Oral Intake Scale (FOIS) and divided based on the FOIS score into the dysphagic and regular diet groups. The changes in oral functions at the three time points were tested using generalized estimating equation analysis. The association between FOIS groups and oral functions at T1 and T2 was analysed by means of logistic regression analysis.

Results: All oral function parameters improved significantly over time during the hospital stay (mean differences: 4.9 for MTP, 0.6 for LTMF, 1.1 for MOF and -1.8 for OHAT). The FOIS groups were significantly associated with MTP (p < .05) and OHAT (p < .05) at both T1 and T2.

Conclusion: Our findings suggest that oral function significantly improves in patients during subacute stroke rehabilitation and better oral health can be associated with better oral intake. Improved oral function through dental intervention and oral rehabilitation may contribute to gains in oral food intake.

Keywords: activities of daily living; dysphagia; functional oral intake scale; oral function; oral health assessment tool; stroke.