Oral Health-related Quality of Life after Stroke

Stroke is a major cause of functional disability in the elderly. Due to stroke-related functional limitation and oral motor impairment, stroke survivors frequently have difficulty maintaining good oral hygiene and the oral problems are common. Oral functional disability after stroke has been shown to undermine not only oral health-related quality of life (OHRQoL) but also QoL in general. Objective: To investigate oral health-related QOL in stroke sufferers over time and compare with a comparison group. Methods: In a prospective longitudinal study, 81 elderly stroke sufferers received an interview and oral clinical examination accordingly on three occasions: during the acute stroke phase, on discharge from hospital and six months later. The control group received the same procedure on one occasion. Data were analysed using paired t-test, wilcoxon Sign Rank test, McNemar test, Mann-whiteney U test and multi-variable analysis. Results: SF-12 and GOHAI score were significantly improved for the stroke sufferers on hospital discharge and six months after hospital discharge (p<0.05). There were significant differences in GOHAI and SF-12 scores between the stroke and comparison groups (p<0.05) with lower scores in stroke group indicating poorer condition. There was progressive improvement in the periodontal condition on hospital discharge and six months after hospital discharge (p<0.05) with fewer tooth sites having moderate to severe plaque and bleeding. The BI score were significantly improved on hospital discharge and six months after hospital discharge (P<0.05). Compared with the comparison group, the stroke group had more tooth sites with moderate to abundant plaque and immediate to spontaneous bleeding (p<0.05).Compared with the comparison group, the stroke group had lower BI scores (p<0.05). Conclusions: Stroke had a prolonged adverse impact on OHRQoL, oral heath condition and functional status although some improvements occurred over time.