Dysphasia with Cerebro-Vascular Accident

• Published in: Ronen Shika Igaku Vol. 9; no. 2; pp. 66 - 72
• Main Authors: Matsuura, Hideo, Niwa, Hitoshi, Kida, Tadayoshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Gerodontology 30.11.1994; 一般社団法人 日本老年歯科医学会
• Subjects: Aspiration pneumonia; Cerebro-vascular accident; Dysphasia; Oral bacterial examination; 口腔内細菌検査; 口腔領域理学的所見; 嚥下障害; 老人性肺炎; 脳血管障害後遺症
• ISSN: 0914-3866; 1884-7323
• DOI: 10.11259/jsg1987.9.66

The deglutition mechanism involves three stages: the first is the buccal pharyngeal stage, the second is the pharyngeal stage, and the third from the esophagus into the stomach. Swallowing is affected by muscle tone, salivation, afferent and efferant function of the cranial nerves V, VII IX, X and XII providing the sensory and motor innervations to the face, lips, tongue and oral cavity. Dysphasia is often observed at the second stage in elderly people with cerebral vascular accident (CVA) and parkinsonism. The secondary effects of dysphasia may cause aspiration pneumonia. We studied the relationship of the oral function and oral hygiene to pneumonia. For the purpose of this study, 31 elders with CVA (CVA group) in a nursing home were examined and compared with 19 elders without CVA (control group). The evaluator should be aware of the resident's present status of food and liquid intake, level of oral hygiene and respiratory status. At first, we investigated the resident's history of continuous fever, cough reflexes and pneumonia. To evaluate the oral function, we examined occlusion, jaw control, tongue control, swallow (liquid-cup and solids) and oral sensory. We used a plaque for bacterial examination. The evaluation of oral hygiene proceeded according to the gingival score index and oral hygine index (OHI). The results were as follows: 1. The CVA group experienced continuous fever more often than the control group. 2. Dysphasia was observed markedly in the CVA group. 3. The CVA group had poor chewing ability, lip closure, tongue control and oral sensitivity. 4. According to the bacterial test, pus-corpuscles were significantly found in CVA group.