Dental management in dysphagia syndrome patients with previously acquired brain damages

Abstract

Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Difficulty in swallowing affects approximately 7% of population, with risk incidence increasing with age. There are many disorder conditions predisposing to dysphagia such as mechanical strokes or esophageal diseases even if neurological diseases represent the principal one. Cerebrovascular pathology is today the leading cause of death in developing countries, and it occurs most frequently in individuals who are at least 60 years old. Swallowing disorders related to a stroke event are common occurrences. The incidence ranging is estimated from 18% to 81% in the acute phase and with a prevalence of 12% among such patients. Cerebral, cerebellar, or brain stem strokes can influence swallowing physiology while cerebral lesions can interrupt voluntary control of mastication and bolus transport during the oral phase. Among the most frequent complications of dysphagia are increased mortality and pulmonary risks such as aspiration pneumonia, dehydration, malnutrition, and long-term hospitalization. This review article discusses the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, diagnostics, and dental management of patients affected.

Keywords: Deglutition disorders; epidemiology; stroke.

Figure 1

Stage of swallowing

Figure 2

Preparation of oral swallowing: physiology

Figure 3

Voluntary transport of the bolus

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Physiological stage of swallowing throat

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Stage of the esophageal swallowing process

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Reduced control of capabilities in the swallowing process

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Clinical evaluation of the dysphagia signs

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Instrumental investigation used for performing diagnosis

Figure 9

Delayed or absent pharyngeal reflex stimulation

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Moment of videofluoroscopy