Association Between Oral Health and Swallowing Function in the Elderly

Takafumi Yamano,1 Kensuke Nishi,1 Fumitaka Omori,2 Kaori Wada,2 Toru Naito3 1Section of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, Fukuoka, 814-0193, Japan; 2Department of Otorhinolaryngology, Fukuoka Dental College Hospital, Fukuoka, 814-0193, Japan; 3Section of Gerodontol...

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Main Authors: Yamano T, Nishi K, Omori F, Wada K, Naito T
Format: Article
Language:English
Published: Dove Medical Press 2023-03-01
Series:Clinical Interventions in Aging
Subjects:
Online Access:https://www.dovepress.com/association-between-oral-health-and-swallowing-function-in-the-elderly-peer-reviewed-fulltext-article-CIA
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author Yamano T
Nishi K
Omori F
Wada K
Naito T
author_facet Yamano T
Nishi K
Omori F
Wada K
Naito T
author_sort Yamano T
collection DOAJ
description Takafumi Yamano,1 Kensuke Nishi,1 Fumitaka Omori,2 Kaori Wada,2 Toru Naito3 1Section of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, Fukuoka, 814-0193, Japan; 2Department of Otorhinolaryngology, Fukuoka Dental College Hospital, Fukuoka, 814-0193, Japan; 3Section of Gerodontology, Department of General Dentistry Fukuoka Dental College, Fukuoka, 814-0193, JapanCorrespondence: Takafumi Yamano, Section of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, 2-15-1 Tamura,Sawara-ku, Fukuoka, 814-0193, Japan, Fax +81 928013678, Email yamano@fdcnet.ac.jpObjective: Although the oral environment significantly affects the risk of pneumonia, there have been few studies regarding its relation with swallowing. There is no doubt that there is a significant link between the oral environment and the development of pneumonia; however, there have been few comparative studies of swallowing using video endoscopy (VE) and video fluorography (VF) as indicators to determine the actual availability of oral intake and the choice of food form. This study was performed to examine whether the oral environment or swallowing function contributes more to the development of pneumonia in the elderly.Methods: The study population consisted of 24 patients (7 men and 17 women; age range: 64– 97 years; average age: 86 years) assessed using the Oral Health Assessment Tool (OHAT), VE and VF at Fukuoka Dental College Hospital. The most common disease was pneumonia (17 patients), followed by cerebral infarction (5 patients), pyelonephritis (4 patients), bronchitis (2 patients), Parkinson’s disease (2 patients), scleroderma (1 patient), diabetes (1 patient), eosophageal cancer (1 patient) and Parkinson’s syndrome> (1 patient). Some patients had multiple diseases. Oral intake was possible in 20 patients (80%), whereas tube feeding and gastric banding were required in 4 patients.Results: The OHAT score was not correlated with either the VE or VF score. Furthermore, the OHAT score was not significantly different between the multiple- and no/single-pneumonia episode groups. The group with multiple episodes of pneumonia had lower VE and VF scores than those with no or only a single episode of pneumonia.Conclusion: Oral assessment, VE and VF are necessary to evaluate swallowing in patients with suspected dysphagia. Swallowing function, especially as assessed by VE and VF, is more important than examination of the oral environment for evaluating risk of recurrent aspiration pneumonia in the elderly. In addition, multiple factors contribute to recurrent pneumonia in patients with a good oral environment, including subclinical aspiration, pharyngeal clearance and delayed activation of the gag reflex.Keywords: dysphagia, Oral Health Assessment Tool, video endoscopy, video fluorography
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spelling doaj.art-1547fff12a5d461587625d38b41719542023-03-07T18:15:45ZengDove Medical PressClinical Interventions in Aging1178-19982023-03-01Volume 1834335182047Association Between Oral Health and Swallowing Function in the ElderlyYamano TNishi KOmori FWada KNaito TTakafumi Yamano,1 Kensuke Nishi,1 Fumitaka Omori,2 Kaori Wada,2 Toru Naito3 1Section of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, Fukuoka, 814-0193, Japan; 2Department of Otorhinolaryngology, Fukuoka Dental College Hospital, Fukuoka, 814-0193, Japan; 3Section of Gerodontology, Department of General Dentistry Fukuoka Dental College, Fukuoka, 814-0193, JapanCorrespondence: Takafumi Yamano, Section of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, 2-15-1 Tamura,Sawara-ku, Fukuoka, 814-0193, Japan, Fax +81 928013678, Email yamano@fdcnet.ac.jpObjective: Although the oral environment significantly affects the risk of pneumonia, there have been few studies regarding its relation with swallowing. There is no doubt that there is a significant link between the oral environment and the development of pneumonia; however, there have been few comparative studies of swallowing using video endoscopy (VE) and video fluorography (VF) as indicators to determine the actual availability of oral intake and the choice of food form. This study was performed to examine whether the oral environment or swallowing function contributes more to the development of pneumonia in the elderly.Methods: The study population consisted of 24 patients (7 men and 17 women; age range: 64– 97 years; average age: 86 years) assessed using the Oral Health Assessment Tool (OHAT), VE and VF at Fukuoka Dental College Hospital. The most common disease was pneumonia (17 patients), followed by cerebral infarction (5 patients), pyelonephritis (4 patients), bronchitis (2 patients), Parkinson’s disease (2 patients), scleroderma (1 patient), diabetes (1 patient), eosophageal cancer (1 patient) and Parkinson’s syndrome> (1 patient). Some patients had multiple diseases. Oral intake was possible in 20 patients (80%), whereas tube feeding and gastric banding were required in 4 patients.Results: The OHAT score was not correlated with either the VE or VF score. Furthermore, the OHAT score was not significantly different between the multiple- and no/single-pneumonia episode groups. The group with multiple episodes of pneumonia had lower VE and VF scores than those with no or only a single episode of pneumonia.Conclusion: Oral assessment, VE and VF are necessary to evaluate swallowing in patients with suspected dysphagia. Swallowing function, especially as assessed by VE and VF, is more important than examination of the oral environment for evaluating risk of recurrent aspiration pneumonia in the elderly. In addition, multiple factors contribute to recurrent pneumonia in patients with a good oral environment, including subclinical aspiration, pharyngeal clearance and delayed activation of the gag reflex.Keywords: dysphagia, Oral Health Assessment Tool, video endoscopy, video fluorographyhttps://www.dovepress.com/association-between-oral-health-and-swallowing-function-in-the-elderly-peer-reviewed-fulltext-article-CIAdysphagiaoral health assessment toolvideo endoscopyvideo fluorography
spellingShingle Yamano T
Nishi K
Omori F
Wada K
Naito T
Association Between Oral Health and Swallowing Function in the Elderly
Clinical Interventions in Aging
dysphagia
oral health assessment tool
video endoscopy
video fluorography
title Association Between Oral Health and Swallowing Function in the Elderly
title_full Association Between Oral Health and Swallowing Function in the Elderly
title_fullStr Association Between Oral Health and Swallowing Function in the Elderly
title_full_unstemmed Association Between Oral Health and Swallowing Function in the Elderly
title_short Association Between Oral Health and Swallowing Function in the Elderly
title_sort association between oral health and swallowing function in the elderly
topic dysphagia
oral health assessment tool
video endoscopy
video fluorography
url https://www.dovepress.com/association-between-oral-health-and-swallowing-function-in-the-elderly-peer-reviewed-fulltext-article-CIA
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