Oral Health and Vitamin D in Stroke Patients
Condition: Stroke; Oral Disease; D Vitamin Deficiency
MeSH terms: Mouth Diseases; Stroke; Avitaminosis; Vitamin D Deficiency
Study type: Observational

Summary: 
      Stroke is a common, serious and restrictive global health problem. Restricting the activities
      of daily living of stroke patients impairs patients' ability to pay attention to oral
      hygiene. Facial paresis and tongue weakness due to stroke may cause a decrease in the control
      of dental prostheses and the removal of food residues in the oral cavity. Food residues and
      saliva contaminated with bacteria as a result of poor oral hygiene can result in pneumonia
      when aspirated due to oropharyngeal dysphagia. In the literature, it has been shown that
      there are significant relationships between periodontal health and vitamin D and calcium
      intake, and that dietary supplementation with calcium and vitamin D can improve periodontal
      health, increase bone mineral density in the mandible, and inhibit alveolar bone resorption.
      In line with all these data, our hypothesis in this study is to investigate the relationship
      between oral health and vitamin D levels in stroke patients in rehabilitation units.
    

Detailed description: 
      Stroke is a common, serious and restrictive global health problem. In most countries, stroke
      is among the second or third most common cause of death and is one of the main causes of
      acquired disability in adults. Although the first attack is usually not fatal in stroke
      patients, it can often have long-term consequences for patients and their families. Although
      notable advances have been made in the medical management of stroke, treatment for most
      stroke patients is based on care and rehabilitation. Motor, perceptual, and cognitive
      impairments after stroke can have adverse effects on daily functions, reducing health-related
      quality of life. Restricting the activities of daily living of stroke patients impairs
      patients' ability to pay attention to oral hygiene. Facial paresis and tongue weakness due to
      stroke may cause a decrease in the control of dental prostheses and the removal of food
      residues in the oral cavity. Food residues and saliva contaminated with bacteria as a result
      of poor oral hygiene can result in pneumonia when aspirated due to oropharyngeal dysphagia.In
      addition, reduced tongue pressure fails to push the food bolus into the pharynx. Decreased
      lip strength causes saliva to flow during chewing. Hyposalivation causes a lack of
      lubrication in the oral mucosa. Abnormal oral sensory function, rapid and improper swallowing
      of food causes choking and aspiration, and aspiration pneumonia. Incompatible orofacial
      function leads to low chewing efficiency, limited food selection, and malnutrition. In
      addition, the risk of poor periodontal health is associated with stroke recurrence and more
      severe stroke. Third, severe periodontitis, which leads to decreased bite force and increased
      tooth mobility during chewing, impairs chewing and food intake, affecting oral health
      conditions.Vitamin D plays a critical role in mediating calcium absorption and regulating
      musculoskeletal health.There are reports of the benefit of vitamin D and calcium
      supplementation in the treatment of periodontal disease. Some previous studies reported that
      calcium and vitamin D supplementation reduced tooth loss and alveolar bone resorption, but
      could not reach a clear conclusion because of the heterogeneous composition of the study
      groups or because it did not directly measure periodontal disease status. More recent studies
      have shown that there are significant associations between periodontal health and the intake
      of vitamin D and calcium, and that dietary supplementation with calcium and vitamin D can
      improve periodontal health, increase bone mineral density in the mandible, and inhibit
      alveolar bone resorption. In line with all these data, our hypothesis in this study is to
      investigate the relationship between oral health and vitamin D levels in stroke patients in
      rehabilitation units.
    

Intervention name(s): Clinical examination, functional status evaluation
Intervention type(s): Other
Intervention description(s): Barthel Index, Oral Health Impact Profile 14, Beck Depression Inventory, Stroke Impact Scale 3, Plaque Index, Calculus Index, Periodontal Disease Index, Simplified Oral Hygiene Index assesment, DMFT Index
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Stroke patients and healthy control group will be included in the study.