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The components and the salivary flow have a direct influence on the composition of the oral microbiota of children and young people with oropharyngeal dysphagia, and studies have already demonstrated the excessive accumulation of supragingival dental calculus in individuals with enteral nutrition. This study aimed to compare the oral hygiene, biochemical, and microbiological aspects of the oral cavity of children and young people with neurological impairment and oropharyngeal dysphagia. Forty children and young people with neurological impairment and oropharyngeal dysphagia were enrolled and divided into two groups: group I, encompassing 20 participants fed via gastrostomy; and group II, encompassing 20 participants fed via the oral route. Oral hygiene and salivary pH and flow were assessed, and a polymerase chain reaction was performed to evaluate the messenger RNA expressions of Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola. In groups I and II, the mean Oral Hygiene Index-Simplified scores were 4 and 2, respectively, showing a significant difference; the mean Calculus Index scores were 2 and 0, respectively, showing a significant difference; and the mean pH was 7.5 and 6.0, respectively, showing a significant difference. Bacterial analysis indicated no association between the two groups. It can be concluded that children and young people who use gastrostomy had a poorer oral hygiene, greater dental calculus deposition, and higher salivary pH. The saliva of patients in both groups contained Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola.

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Aim: We aimed to analyze the relationship between tongue measurements and vallecular residue in patients with amyotrophic lateral sclerosis (ALS). Materials & methods: Twenty-one patients with ALS were assessed for posterior maximum tongue isometric pressure (PMTIP) and posterior tongue isometric endurance (PTIE) by the Iowa Oral Performance Instrument; vallecular residue after 10 ml of moderately thickened consistency by Fiberoptic Endoscopic Evaluation of Swallowing; and tongue thickness (TT) by ultrasonography. Results: PMTIP, PTIE and TT were decreased compared with the reference values for healthy individuals and were not different between patients with and without vallecular residue. Conclusion: In ALS, PMTIP, PTIE and TT are not good predictors of vallecular residue in the tested volume and food consistency.

Lay abstract This study aimed to analyze the relationship of measurable characteristics of the tongue in patients with amyotrophic lateral sclerosis (ALS) and the accumulation of residue after swallowing in an area located just after the tongue. This accumulation of residue provides a sensation of bolus stuck in the throat and increases the risk of weight loss, choking and pulmonary complications. Twenty-one ALS patients were assessed for tongue pressure, tongue endurance, tongue thickness and residue after swallowing of the 10 ml of moderately thickened consistency. This study concluded that all tongue measurements were low in ALS patients with and without residue. Therefore, these tongue measurements are not good predictors of vallecular residue in the tested volume and food consistency.

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This study compared the oral hygiene and oral microbiota in children and young people with neurological impairment and oropharyngeal dysphagia with and without gastrostomy. Forty children and young people participated in this study: 19 females and 21 males, aged 2 to 22 years (mean age 8.6 years). Participants were divided into two groups: group I (GI = 20) with gastrostomy and group II (GII = 20) without gastrostomy (with oral feeding). Oral hygiene was assessed using the Simplified Oral Hygiene Index (SOHI). Analysis of two bacteria, Streptococcus mutans and Streptococcus sobrinus, was performed by collecting saliva using an oral swab, then mRNA expression was evaluated using the polymerase chain reaction (PCR) technique. The oral hygiene index had a general median of 2.2, and the two groups were statistically different (Group I: median 2.9 and Group II: median 2.0) (p = 0.01751). Bacterial analysis indicated 13 individuals with S. mutans and none with S. sobrinus. Of the 13 individuals with S. mutans, 6 were from Group I and 7 from Group II. Those with gastrostomy had worse oral hygiene, and both groups harbored the bacterium S. mutans.

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BACKGROUND: Oropharyngeal dysphagia is a common symptom of many neurological diseases, including Multiple Sclerosis (MS). Early identification of the risk of dysphagia in neurological patients is very important for early referral for specialized evaluations of oropharyngeal swallowing and treatments. The Dysphagia in Multiple Sclerosis (DYMUS) questionnaire has been translated and validated in different countries over the last 10 years. We aimed to analyze the accuracy of the Brazilian Portuguese version of the DYMUS (DYMUS-BR) questionnaire in identifying dysphagia in patients with MS. METHODS: The DYMUS questionnaire and a videofluorographic swallowing study (VFSS) were conducted in 30 patients with MS. Dysphagia was identified by at least one abnormal response and was considered alarming when the DYMUS scores were equal to or higher than 3. Patients were considered to have dysphagia in the VFSS when one or more signs of impairment in the efficiency and/or safety of swallowing were detected. RESULTS: According to the initial self-assessment, 37% (N = 11) of patients with MS self-reported with dysphagia. According to the DYMUS-BR scores, 53% (N = 16) of the patients with MS were classified as having dysphagia. The sensitivity, specificity, and positive and negative predictive values of the DYMUS-BR questionnaire for the detection of dysphagia as measured by the VFSS were 50% [95% confidence interval (CI) 29-71], 78% (95% CI 61-90), 60% (95% CI 42-76), and 70% (95% CI 60-78), respectively. The area under the receiver-operating characteristic curve for detecting dysphagia was 64% (95% CI 49-79). CONCLUSION: The accuracy of the DYMUS-BR questionnaire is poor to detect mild swallowing impairment in patients with MS. However, we suggest longitudinal follow-up in patients with low DYMUS-BR scores for early detection of oropharyngeal dysphagia.

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The objective of present study was compare a traditional swallowing therapy program with a new combined swallowing therapy program including neuromuscular electrical stimulation in patients with oropharyngeal dysphagia after stroke. This pilot study included eight patients with chronic oropharyngeal dysphagia after stroke. These patients underwent traditional therapy with gustative-thermic-tactile stimulation (group A), or a new combined program adding neuromuscular electrical stimulation (group B). Study participants were evaluated before and after the intervention using fiberoptic endoscopic evaluation of swallowing with temporal measures of posterior oral spillage and whiteout time, functional oral intake scale and a visual analog scale classifies an individual's swallowing ability. The two groups did not differ in terms of posterior oral spillage time, whiteout time and functional oral intake scale. Subjects in group B exhibited significant increases in visual analog scale scores. However, both groups demonstrated improvement with decreases in posterior oral spillage time, increased whiteout time, and increased functional oral intake scale and visual analog scale scores. There was no difference in the parameters studied in both therapeutic programs in individuals with chronic oropharyngeal dysphagia after stroke.

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Objectives: To analyze the relationship between pharyngeal response time (PRT) and lateralization of brain lesions. Methods: A Cross-sectional study. 73 videofluoroscopic swallow studies (VFSS)were conducted on patients after stroke The study subjects were divided into : group 1 (G1) consisting of 39 individuals with left cortical lesion and group 2 (G2) consisting of 34 individuals with right cortical lesions. The VFSS of G1 and G2 subjects were analyzed using puree (A) and liquid (B) consistencies, and  were also subdivided into young adults and older persons. . The mean PRT was divided into times shorter and longer than 250 ms. Results: No statistically significant difference was observed between G1 and G2 for the A and B consistencies, being obtained : G1 (A mean: 56.6 ms; B mean: 99.5 ms; A mean: 3627 ms; B mean: 1712 ms) and G2 (A mean: 79.6 ms; B mean: 110.7 ms; A mean: 2040 ms, B mean: 1529 ms), for PRT shorter (A:p = .673; B: p = 1.000) and longer (A: p = .435; B: p = .847) than 250 ms, respectively. No statistically significant difference was found regarding the variable age in the comparison between young and old adults for mean PRT according to the A and B consistencies in G1 (A: p = .260; B: p = .732) and G2 (A: p = .586; B: p = .104). Conclusion: No relationship between PRT and lateralization of brain lesion was observed with respect to subject age and to the swallowing of different food consistencies.

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