Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia

Suzanne Delwel; Erik J.A. Scherder; Cees de Baat; Tarik T. Binnekade; Johannes C. van der Wouden; Cees M.P.M. Hertogh; Andrea B. Maier; Roberto S.G.M. Perez; Frank Lobbezoo

doi:10.1111/joor.12724

Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia

Suzanne Delwel^*
, Erik J.A. Scherder
, Cees de Baat
, Tarik T. Binnekade
, Johannes C. van der Wouden
, Cees M.P.M. Hertogh
, Andrea B. Maier
, Roberto S.G.M. Perez
, Frank Lobbezoo

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND: The number of people with dementia and natural dentition is growing. As dementia progresses, the degree of self-care decreases and the risk of oral health problems and orofacial pain increases.

OBJECTIVES: To examine and compare the presence of orofacial pain and its potential causes in older people with Mild Cognitive Impairment (MCI) or dementia.

METHODS: In this cross-sectional observational study, the presence of orofacial pain and its potential causes was studied in 348 participants with MCI or dementia with all levels of cognitive impairment in two outpatient memory clinics and ten nursing homes.

RESULTS: Orofacial pain was reported by 25.7% of the 179 participants who were considered to present a reliable pain self-report (Mini-Mental State Examination score ≥14 points), while it could not be determined in people with more severe cognitive impairment. The oral health examination of the 348 participants indicated that potential painful conditions, such as coronal caries, root caries, tooth root remnants or ulcers were present in 50.3%. There was a significant correlation between the level of cognitive impairment and the number of teeth, r = 0.185, P = 0.003, teeth with coronal caries, r = -0.238, P < 0.001, and the number of tooth root remnants, r = -0.229, P = 0.004, after adjusting for age.

CONCLUSIONS: This study indicated that orofacial pain and its potential causes were frequently present in participants with MCI or dementia. Therefore, a regular oral examination by (oral) healthcare providers in people with MCI or dementia remains imperative, even if no pain is reported.

Original language	English
Pages (from-to)	23-32
Number of pages	10
Journal	Journal of Oral Rehabilitation
Volume	46
Issue number	1
Early online date	3 Oct 2018
DOIs	https://doi.org/10.1111/joor.12724
Publication status	Published - Jan 2019

Bibliographical note

Funding

This study was supported by grants from Alzheimer Nederland [WE.09-2012-02], Amstelring [RVB U-9107-2013/HM/wb], Arnold Oosterbaan Hersenstichting, Fonds NutsOhra [1130-046], Roomsch Catholijk Oude Armen Kantoor [U-9128-2012 HM/ lw], Stichting Beroepsopleiding Huisartsen (SBOH) and Stichting Henriëtte Hofje. The authors have no conflict of interests to declare. Funding information This study was supported by grants from Alzheimer Nederland [WE.09-2012-02], Amstelring [RVB U-9107-2013/HM/wb], Arnold Oosterbaan Hersenstichting, Fonds NutsOhra [1130-046], Roomsch Catholijk Oude Armen Kantoor [U-9128-2012 HM/lw], Stichting Beroepsopleiding Huisartsen (SBOH) and Stichting Henri?tte Hofje. The authors have no conflict of interests to declare. The authors thank the participants and their care providers for their cooperation with the study. Furthermore, they thank the staff of the outpatient clinics at the VU Medical Center and the Amstelland hospital, and the staff at the ten participating nursing homes of Amstelring, Cordaan and Zonnehuisgroep Amstelland for their cooperation. Moreover, they thank the students of the Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam and the Department of Oral Kinesiology, Academic Center for Dentistry Amsterdam (ACTA) for their assistance. In addition, they thank Drs. Janine van Kooten of the Department of General Practice and Elderly Care Medicine, VU University Medical Center for her help with the acquisition of participants and the collection of the demographic data at the nursing homes.

Funders	Funder number
Academic Center for Dentistry Amsterdam
Arnold Oosterbaan Hersenstichting
Roomsch Catholijk Oude Armen Kantoor	U-9128-2012 HM/ lw
Stichting Henri?tte Hofje
Stichting Henriëtte Hofje
VU Medical Center
Fonds NutsOhra	1130-046
Stichting Beroepsopleiding Huisarts

Keywords

aged
cognitive dysfunction
facial pain
geriatric dentistry
oral health
toothache

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title = "Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia",

abstract = "BACKGROUND: The number of people with dementia and natural dentition is growing. As dementia progresses, the degree of self-care decreases and the risk of oral health problems and orofacial pain increases.OBJECTIVES: To examine and compare the presence of orofacial pain and its potential causes in older people with Mild Cognitive Impairment (MCI) or dementia.METHODS: In this cross-sectional observational study, the presence of orofacial pain and its potential causes was studied in 348 participants with MCI or dementia with all levels of cognitive impairment in two outpatient memory clinics and ten nursing homes.RESULTS: Orofacial pain was reported by 25.7\% of the 179 participants who were considered to present a reliable pain self-report (Mini-Mental State Examination score ≥14 points), while it could not be determined in people with more severe cognitive impairment. The oral health examination of the 348 participants indicated that potential painful conditions, such as coronal caries, root caries, tooth root remnants or ulcers were present in 50.3\%. There was a significant correlation between the level of cognitive impairment and the number of teeth, r = 0.185, P = 0.003, teeth with coronal caries, r = -0.238, P < 0.001, and the number of tooth root remnants, r = -0.229, P = 0.004, after adjusting for age.CONCLUSIONS: This study indicated that orofacial pain and its potential causes were frequently present in participants with MCI or dementia. Therefore, a regular oral examination by (oral) healthcare providers in people with MCI or dementia remains imperative, even if no pain is reported.",

keywords = "aged, cognitive dysfunction, facial pain, geriatric dentistry, oral health, toothache",

author = "Suzanne Delwel and Scherder, \{Erik J.A.\} and \{de Baat\}, Cees and Binnekade, \{Tarik T.\} and \{van der Wouden\}, \{Johannes C.\} and Hertogh, \{Cees M.P.M.\} and Maier, \{Andrea B.\} and Perez, \{Roberto S.G.M.\} and Frank Lobbezoo",

note = "{\textcopyright} 2018 The Authors. Journal of Oral Rehabilitation Published by John Wiley \& Sons Ltd.",

year = "2019",

month = jan,

doi = "10.1111/joor.12724",

language = "English",

volume = "46",

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T1 - Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia

AU - Delwel, Suzanne

AU - Scherder, Erik J.A.

AU - de Baat, Cees

AU - Binnekade, Tarik T.

AU - van der Wouden, Johannes C.

AU - Hertogh, Cees M.P.M.

AU - Maier, Andrea B.

AU - Perez, Roberto S.G.M.

AU - Lobbezoo, Frank

PY - 2019/1

Y1 - 2019/1

N2 - BACKGROUND: The number of people with dementia and natural dentition is growing. As dementia progresses, the degree of self-care decreases and the risk of oral health problems and orofacial pain increases.OBJECTIVES: To examine and compare the presence of orofacial pain and its potential causes in older people with Mild Cognitive Impairment (MCI) or dementia.METHODS: In this cross-sectional observational study, the presence of orofacial pain and its potential causes was studied in 348 participants with MCI or dementia with all levels of cognitive impairment in two outpatient memory clinics and ten nursing homes.RESULTS: Orofacial pain was reported by 25.7% of the 179 participants who were considered to present a reliable pain self-report (Mini-Mental State Examination score ≥14 points), while it could not be determined in people with more severe cognitive impairment. The oral health examination of the 348 participants indicated that potential painful conditions, such as coronal caries, root caries, tooth root remnants or ulcers were present in 50.3%. There was a significant correlation between the level of cognitive impairment and the number of teeth, r = 0.185, P = 0.003, teeth with coronal caries, r = -0.238, P < 0.001, and the number of tooth root remnants, r = -0.229, P = 0.004, after adjusting for age.CONCLUSIONS: This study indicated that orofacial pain and its potential causes were frequently present in participants with MCI or dementia. Therefore, a regular oral examination by (oral) healthcare providers in people with MCI or dementia remains imperative, even if no pain is reported.

AB - BACKGROUND: The number of people with dementia and natural dentition is growing. As dementia progresses, the degree of self-care decreases and the risk of oral health problems and orofacial pain increases.OBJECTIVES: To examine and compare the presence of orofacial pain and its potential causes in older people with Mild Cognitive Impairment (MCI) or dementia.METHODS: In this cross-sectional observational study, the presence of orofacial pain and its potential causes was studied in 348 participants with MCI or dementia with all levels of cognitive impairment in two outpatient memory clinics and ten nursing homes.RESULTS: Orofacial pain was reported by 25.7% of the 179 participants who were considered to present a reliable pain self-report (Mini-Mental State Examination score ≥14 points), while it could not be determined in people with more severe cognitive impairment. The oral health examination of the 348 participants indicated that potential painful conditions, such as coronal caries, root caries, tooth root remnants or ulcers were present in 50.3%. There was a significant correlation between the level of cognitive impairment and the number of teeth, r = 0.185, P = 0.003, teeth with coronal caries, r = -0.238, P < 0.001, and the number of tooth root remnants, r = -0.229, P = 0.004, after adjusting for age.CONCLUSIONS: This study indicated that orofacial pain and its potential causes were frequently present in participants with MCI or dementia. Therefore, a regular oral examination by (oral) healthcare providers in people with MCI or dementia remains imperative, even if no pain is reported.

KW - aged

KW - cognitive dysfunction

KW - facial pain

KW - geriatric dentistry

KW - oral health

KW - toothache

UR - https://www.scopus.com/pages/publications/85055254015

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UR - https://hdl.handle.net/11245.1/cd568585-0984-4b06-897b-e2f8117fc4ed

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M3 - Article

C2 - 30281826

SN - 0305-182X

VL - 46

SP - 23

EP - 32

JO - Journal of Oral Rehabilitation

JF - Journal of Oral Rehabilitation

IS - 1

ER -

Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia

Abstract

Bibliographical note

Funding

Keywords

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