Factors Related to Oral Problems in Patients with Prolonged Disorders of Consciousness in Long-Term Care: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
- Age, sex, the number of years since the onset of the disorder, and the cause of onset.
- Physical function: walking with assistance, sitting (end sitting position), sitting (with backrest), can only roll over, and total assistance.
- Communication disorder: communicating with words, only speaking words, only emotional expressions, and no emotional expressions.
- Respiratory care: none, oxygen administration, simple tracheostomy, or laryngo-tracheal separation.
- Drooling and airway suctioning: none, rarely, sometimes, and every day.
- Food intake: total oral diet, tube-dependent with oral intake of food or liquid, and nothing by mouth.
- Oral problems: malocclusion, inability to open or close the mouth, dislocation of the temporomandibular joint, and glossoptosis. Multiple answers were considered acceptable. Excludes problems, such as dental caries, periodontal disease, and mucosal diseases.
- Presence of a family dentist: none, a dental office, house call dentistry, a university hospital, and others.
2.2. Data Analysis
3. Results
3.1. Participant Characteristics
3.2. Comparisons Based on the Presence of Oral Problems
3.3. Factors Affecting Oral Problems
4. Discussion
4.1. Relationship between Oral Function and Malocclusion
4.2. Relationship between Swallowing Function and Oral Problems
4.3. Dental Approach to Oral Problems
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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N (%) | ||
---|---|---|
Age, median (min.–max.) | 60 (30–81) | |
Number of years since onset, median (min.–max.) | 12 (5–32) | |
Sex | Male | 82 (65) |
Female | 45 (35) | |
Cause of onset | Traffic injuries | 67 (52.8) |
Cerebrovascular disease | 20 (15.7) | |
Hypotonic ischemic encephalopathy | 16 (12.6) | |
Medical accidents | 8 (6.3) | |
Cardiovascular disease | 6 (4.7) | |
Other diseases | 2 (1.6) | |
Industrial accidents | 1 (0.8) | |
Others | 7 (5.5) | |
Physical function | Walking with help | 6 (5) |
Sitting position | 54 (43) | |
Can only roll over | 7 (5) | |
Total assistance | 61 (47) | |
Communication disorder | Communication with words | 10 (8) |
Only speak words | 10 (8) | |
Only emotional expression | 77 (61) | |
No emotional expression | 28 (23) | |
Respiratory care | None | 39 (32) |
Oxygen administration | 10 (8) | |
Tracheostomy | 65 (53) | |
Laryngo-tracheal separation | 8 (7) | |
Drooling | None | 26 (21) |
Rarely | 23 (19) | |
Sometimes | 34 (28) | |
Every day | 40 (32) | |
Airway suctioning | None | 32 (32) |
Less than 10 times a day | 34 (33) | |
More than 10 times a day | 35 (35) | |
Oral intake status | Total oral diet | 15 (12) |
Tube-dependent with oral intake of food or liquid | 46 (37) | |
Nothing by mouth | 64 (51) | |
Oral problems (Multiple answers allowed) | None | 25 (20) |
Malocclusion | 72 (57) | |
Unable to open and close the mouth | 37 (28) | |
Dislocation of TMJ | 7 (6) | |
Glossoptosis | 24 (18) | |
Others | 14 (11) | |
Presence of a family dentist | None | 24 (20) |
A dental office | 7 (6) | |
Domiciliary dentistry | 71 (59) | |
A university hospital | 9 (7) | |
Others | 10 (8) |
Oral Problems | p-Value | |||
---|---|---|---|---|
Absent (N = 25) | Present (N = 102) | |||
Age | Median (min.-max.) | 59 (30–76) | 63 (30–81) | 0.345 † |
Number of years since onset | Median (min.-max.) | 11 (5–18) | 13 (5–32) | 0.751 † |
Sex | Male | 17 | 65 | 0.922 ‡ |
Female | 9 | 36 | ||
Physical function | Total assistance | 12 | 49 | 0.849 ‡ |
Communication disorder | Only facial expression | 17 | 60 | 0.578 ‡ |
Respiratory care | Tracheotomy | 16 | 49 | 0.768 ‡ |
Drooling | None | 10 | 16 | 0.031 ‡* |
Airway suctioning | More than 10 times a day | 3 | 32 | 0.049 ‡* |
Oral intake status | Nothing by mouth: tube feeding only | 9 | 55 | 0.043 ‡* |
Presence of a family dentist | Presence | 18 | 69 | 0.142 ‡ |
Odds Ratio Exp(β) | 95% CI | p-Value | ||
---|---|---|---|---|
Age | 0.98 | 0.94 | 1.02 | 0.314 |
Number of years since onset | 1.50 | 0.99 | 1.22 | 0.046 * |
Drooling | 1.11 | 0.72 | 1.74 | 0.626 |
Oral intake status | 2.05 | 1.16 | 2.96 | 0.010 * |
Presence of a family dentist | 1.00 | 0.65 | 1.56 | 0.993 |
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Yoshimi, K.; Nakagawa, K.; Yamaguchi, K.; Nakane, A.; Hayashi, M.; Miyata, R.; Chiba, Y.; Tohara, H. Factors Related to Oral Problems in Patients with Prolonged Disorders of Consciousness in Long-Term Care: A Cross-Sectional Study. Healthcare 2023, 11, 1622. https://doi.org/10.3390/healthcare11111622
Yoshimi K, Nakagawa K, Yamaguchi K, Nakane A, Hayashi M, Miyata R, Chiba Y, Tohara H. Factors Related to Oral Problems in Patients with Prolonged Disorders of Consciousness in Long-Term Care: A Cross-Sectional Study. Healthcare. 2023; 11(11):1622. https://doi.org/10.3390/healthcare11111622
Chicago/Turabian StyleYoshimi, Kanako, Kazuharu Nakagawa, Kohei Yamaguchi, Ayako Nakane, Masaharu Hayashi, Rie Miyata, Yumi Chiba, and Haruka Tohara. 2023. "Factors Related to Oral Problems in Patients with Prolonged Disorders of Consciousness in Long-Term Care: A Cross-Sectional Study" Healthcare 11, no. 11: 1622. https://doi.org/10.3390/healthcare11111622
APA StyleYoshimi, K., Nakagawa, K., Yamaguchi, K., Nakane, A., Hayashi, M., Miyata, R., Chiba, Y., & Tohara, H. (2023). Factors Related to Oral Problems in Patients with Prolonged Disorders of Consciousness in Long-Term Care: A Cross-Sectional Study. Healthcare, 11(11), 1622. https://doi.org/10.3390/healthcare11111622