Neuro-Muscular Dentistry: the “diamond” concept of electro-stimulation potential for stomato-gnathic and oro-dental conditions

Oro-Pharyngeal Dysphagia - or simply dysphagia - is the difficulty (persistent) in swallowing/passing food and/or liquid from the mouth to the pharynx into the esophagus and finally the stomach; a deglutition disorder (a symptom, by definition, often due to neuro-degenerative/−muscular, drug-induced or localized structural pathologies such as head and neck tumors, lesions and associated surgical and/or radiation injuries) linked to severe consequences on Quality of Life (QoL), including malnutrition, dehydration, and even sudden death. Likewise, Temporo-Mandibular Jaw and Joint disorder(s) – or simply TMD – is a multifactorial etiological condition, regularly encountered in the dental office. Whether due to malocclusion, bruxism, stress and/or trauma, TMD destabilizes the whole cranio-mandibular system structurally and functionally, via affecting mastication, teeth, supporting structures, comfort and aesthetics, and thus, QoL, again. While several treatment regimens do exist for such conditions, some of which have been standardized for use over the years, most continue to lack proper evidence-based literature support. Hence, (1) caution is to be exercised; and (2) the need for alternative therapeutic strategies is amplified, subsequently, the door for innovation is wide open. Indeed, neuromuscular electrical stimulation or “NMES”, is perhaps a fine example. Herein, we present the interested oro-dental health care provider with an up-dated revision of this therapeutic modality, its potential benefits, risks and concerns, to best handle the dysphagic patient: an intra-disciplinary approach or strategy bridging contemporary dentistry with speech and language therapy; a rather obscure and un-discovered yet critical allied health profession. A pre-clinical and clinical prospectus on employing inventive NMES-based regimens and devices to manage TMD is also highlighted.

Dentistry considerations for the dysphagic patient: Recognition of condition and management

Dysphagia is a symptom of various underlying medical conditions. It can be attributed to age related changes, neurological, cognitive, respiratory and gastrointestinal diseases. These conditions may cause functional and anatomical changes along the swallowing tract. Impaired swallowing function and oromotor insufficiencies may result in inadvertent aspiration of fluids and/or particles during dental procedures. This article attempts to highlight the importance of identifying patients with dysphagia and discusses ways to reduce life threatening conditions that may arise during dental procedures.

The THE MULTIDISCIPLINARY TEAM'S PERFORMANCE IN DYSPHAGIC PATIENTS CARE IN THE HOSPITAL ENVIRONMENT: integrative review of literature

This article is an integrative review of the literature aiming to gather and synthesize the results of studies and research in order to know the productions of scientific knowledge related to the performance of the multidisciplinary team for the dysphagic person care in the hospital environment. The research was performed during the month of November of 2017, using BIREME, PUBMED and SCIELO databases, in Portuguese, English and Spanish. The following keywords were used in combination: hospital, dysphagia and patient care team. As exclusion criteria were determined: articles not related to the theme and not fully available in the databases. After going through the keywords, languages and period of publication (2007-2017) criteria, there were 89 publications remaining, and after the exclusion criteria only (n = 75) were left, of which only 14 publications were selected for the present review. The present study contemplated information concerning authors, Journal, research title, type of study, objective and conclusion. Before the publications analyzed, it is noticed that there is little scientific material that reports the performance of a multidisciplinary team in the dysphagic patient care, and there is a need for more research in this area, since today dysphagia is increasingly present within the intensive care unit, especially in the elderly patient