Website of the Department of Health

In an attempt to construct a carer-friendly assessment sheet of an edentulous stroke patients' circum-denture musculature, a modification of a speech therapy screening chart (Frenchay) was utilised. The resultant chart enables the clinicians to assess muscle tone via asking stroke patients to perform normally straight-forward tasks. Assessment was made of the control of jaws at rest, lip control, tongue control and buccinator control. The chart and the assessment therein proved easy to perform and in the pilot study of thirty patients, intra and inter examiner reproducibility assessments proved to be statistically acceptable (vide infra).

In the study proper it was determined that while it was relatively easy to determine the level of control a patient had over her/his circum-denture musculature, it was more problematic to assess whether denture wearing was likely to be tolerated owing to the fact that many patients were not wearing dentures, or the guidelines may be used to help prescribe sensible treatment options for stroke patients.

We feel that this chart enables easy assessment of a stroke victim's circum-denture musculature and will enable more appropriate treatment planning. The unambiguous nature of the chart resulted in very acceptable reproducibility (Kappa statistic of 0.9).

The findings from this research have now been collated and will be submitted for publication in a specialist internal dental journal (Gerodontology/Special Care in Dentistry).

Our findings enable clinicians, or appropriately trained carers to assess circum-denture muscle control in patients. Using a binary scale, it is possible to determine which cases are likely to demonstrate major problems of denture stability and therefore those cases where denture wearing needs to be facilitated. This factor assumes greater importance if one considers swallowing and the fact that impaired swallowing in stroke victims, e.g. those unable to wear dentures, may be related to infections of the respiratory tract.