Poor Oral Health in Adults and Older Adults: A Cross-Sectional Analysis of Videofluoroscopic Swallowing Studies

Abstract

To identify oral health variables associated with laryngotracheal aspiration-related outcomes as determined by swallowing during videofluoroscopy in adults and older adults. This cross-sectional study included 225 persons aged 18 years or older who were referred for clinical evaluation and videofluoroscopy examination due to suspected dysphagia. Oral health status assessment comprised self-reported the number of teeth, use and fit of dentures, xerostomia and satisfaction with chewing. The number of teeth and fit of dentures were also assessed clinically by a speech therapist. Videofluoroscopy followed a standardized protocol. The presence and severity of dysphagia was assessed using the O'Neill Swallowing Scale. The Dysphagia Severity and Outcome Scale defined the occurrence of laryngotracheal penetration or aspiration of food. Results were presented as prevalence ratios and 95% confidence intervals. Poisson regressions with robust variance ran on R version 4.2.1. were used to estimate associations with dysphagia and aspiration. In the multivariate models for aspiration, the following factors were associated with the upper arch: Partial dentition with poorly fitted implants, fixed prostheses (single or multiple), or removable partial dentures (PR, 3.45; 95% CI, 1.15-10.41), partial dentition without rehabilitation with prosthesis (PR, 4.05; 95% CI, 1.46-11.22), edentulism with well-fitted conventional total prosthesis (PR, 4.82; 95% CI, 1.29-17.92), and edentulism without complete dentures (PR, 7.22; 95% CI, 2.25-23.10). For the lower arch, associated factors included: Edentulism with poorly fitted conventional total prosthesis (PR, 8.99; 95% CI, 1.85-43.44), partial dentition without prosthesis (PR, 6.76; 95% CI, 1.67-27.84), and edentulism without prosthesis (PR, 8.69; 95% CI, 1.86-40.63). This study highlights the significant association between poor oral health, dysphagia, and aspiration laryngotracheal, underscoring the need for integrated care between speech-language pathology and dentistry. Our findings provide a foundation for future research that incorporates more robust research designs and oral examinations to explore underlying mechanisms explaining the relation between oral health, dysphagia, and aspiration.

Keywords: Deglutition; Deglutition disorders; Dental prosthesis; Dentistry; Oral health.