Nationwide Survey of Oral Function Management in Patients With Neuromuscular Intractable Diseases in Japan

We investigated the current situation and problems associated with dental treatment for patients with neuromuscular intractable diseases at medical institutions in Japan.

Questionnaires were sent to 658 dental medicine institutions nationwide. Between October 25 and December 31, 2021, we targeted dental hospitals, dental and oral surgery departments from university hospitals, and dental treatment facilities registered with the Japanese Society of Disability Dentistry that had pediatric dentistry, disability dentistry, or eating function therapy departments. A questionnaire survey was conducted on the following topics: whether or not the dental clinic had experience in treating patients with neuromuscular disorders, breakdown of diseases and annual number of patients, oral symptoms, treatment content, frequency of hospital visits, problems faced by patients and their families in terms of dental treatment, and points that dental healthcare professionals pay particular attention to when treating patients.

Responses were received from 215 facilities. Muscular dystrophy was the most common disease affecting patients who were treated in the course of a year, accounting for approximately 40% of the total. The most common oral symptom was periodontitis, and the treatment for it consisted of oral care (including removal of tartar and plaque), performed in approximately half of the patients, followed by general dental treatment and swallowing training. Oral care was carried out regularly. The main problems faced by the patients were difficulties with self-care on the part of the patients and their families, and difficulties with attending hospital appointments due to a lack of social support. Lack of acceptance at local dental clinics was also mentioned. Treatment considerations that required particular attention from the medical staff were the most frequent, with the most common being adequate positioning to prevent aspiration and ensure appropriate suction. In addition, a third party was requested to accompany the patient when attending hospital appointments, and vital signs were checked during treatment.

Many patients with neuromuscular syndromes have oral diseases such as periodontitis and dental caries, as well as dysphagia, and require the intervention of dentists. However, dental professionals may not always be prepared to accept these patients. It is urgent for dentists to deepen their knowledge about the appropriate treatment for these patients and build a system capable of accepting them, while maintaining close cooperation with the medical profession.