A preliminary investigation into tooth care, dental attendance and oral health related quality of life in adult stroke survivors in Tayside, Scotland.

Objective: The aim of this study was to investigate patterns of oral care, dental attendance and oral health-related quality of life among adults who had suffered a stroke.

Background: Stroke is the most common cause of adult disability in the UK. Seventy per cent of strokes occur in adults over 65 years of age. A mild stroke may leave little residual disability but in cases of moderate or severe stroke the disability may be significant and may impact on oral health and function.

Materials And Methods: A cross-sectional survey was conducted among adults surviving 1 year after stroke, between January and July 2001. A medical screening was carried out which included an assessment of disability and handicap using the modified Rankin scale. A structured interview was conducted to identify normal patterns of oral care and dental attendance and to elicit if since suffering a stroke any changes had occurred or were likely to occur. The Short Form Oral Health Impact Profile (OHIP-14) was administered prior to an oral examination. Analysis used SPSS 11.0 for Windows. Parametric and nonparametric tests were undertaken (t-tests and chi-squared tests with Yates correction where appropriate).

Results: Forty-one adults were recruited into the study comprising 21 female and 20 male. They ranged in age from 50 to 87 years and the mean age was 69 years (SD = 9.8). Forty per cent of participants experienced moderate disability or greater following their stroke. Thirty-seven per cent had difficulty with tooth cleaning. The most frequently reported problem was being unable to use one hand properly as a result of the stroke. There was a significant association between the degree of disability following stroke and difficulty with tooth cleaning (P = 0.015). Disability as a result of the stroke was cited as the main reason for reported or projected attendance pattern change. The most frequently experienced OHIP-14 dimension was functional limitation (39%).

Conclusion: Individuals who have been left disabled after a stroke may require help with or advice on oral care and information on how to access dental services in a setting appropriate to their disability. Further research is needed to identify the dental needs of adults with stroke and to identify appropriate interventions to meet these needs.