The Repercussions of Amyotrophic Lateral Sclerosis on the Orofacial Sphere: A One-Year Prospective Longitudinal Study

The aim of this longitudinal study was to evaluate the repercussions of amyotrophic lateral sclerosis (ALS) on orofacial function, dental health, and the development of malocclusions, in order to assess whether disease progression influences oral and craniofacial outcomes.

Thirteen patients diagnosed with ALS according to the Gold Coast criteria were enrolled to be examined at two time points (T1 and T2), with a one-year interval. The ALS Functional Rating Scale-Revised (ALS-FRS-R), the Nordic Orofacial Test Screening (NOT-S), the Decayed Missing and Filled Teeth (DMFT) index, Plaque Index, and standard orthodontic assessments were used to quantify changes in disease progression, orofacial function, dental health, and occlusal parameters, respectively. Statistical evaluation: Paired sample t-tests were performed to evaluate differences between T1 and T2 for continuous variables. Chi-square and Fisher's exact tests were used for categorical data. Multiple linear regression analyses were carried out to assess potential associations between general disease progression, ALS type, and orofacial functional or dental health decline. A significance level of p < 0.05 was adopted for all analyses.

Thirteen patients were examined at T1, 10 of whom completed both evaluations. A significant deterioration in the general disease condition was observed (ALS-FRS-R: mean difference -6.0 ± 6.98; p = 0.024). Orofacial function worsened significantly as reflected by an increase in NOT-S total score (+2.3; p = 0.001). Dental health also declined, with a significant increase in DMFT (+1.8; p = 0.014) and Plaque Index (+0.4; p = 0.004). However, occlusal parameters remained stable over the 12-month period, with no significant changes in overjet (p = 0.860) or overbite (p = 0.347). The bulbar type of ALS seems to show worse deterioration of orofacial function over time, and individuals with more significant general disease progression also showed worse orofacial functional decline.

ALS has a significant impact on orofacial function and dental health, characterized by neuromuscular deterioration, increased plaque accumulation, and a higher number of affected teeth. Despite this decline, dental occlusion appears to remain stable in the short term. These findings highlight the need for interdisciplinary and preventive oral care strategies in the management of patients with ALS, aiming to preserve oral function and quality of life in a progressively disabling disease.