Predictors of patients' satisfaction after temporomandibular disorder treatment in a referral clinic.

BACKGROUND: Evaluating patients' satisfaction after received care for temporomandibular disorders (TMD) pain provides oral health care professionals with knowledge and tools to improve their clinical procedures. However, knowledge on patient characteristics that determine satisfaction with the received care for TMD pain is lacking. OBJECTIVE: To identify potential baseline predictors for patients' satisfaction regarding the management of TMD pain upon treatment completion in a referral clinic. METHODS: Eligible patients, viz., individuals of ≥16 years of age, with a TMD-pain diagnosis according the diagnostic criteria for TMD (DC/TMD), and who were treated in a referral clinic, were included. As part of their standard care, a set of diagnostic questionnaires was filled in (e.g. TMD-pain screener, graded chronic pain scale (GCPS), etc.). After completion of the received care, patients filled in a custom-made questionnaire based on patient reported experience measures (PREMs) to quantify their satisfaction with their treatment results and received care. To identify potential predictors associated with patients' satisfaction, univariate and multivariate linear regression analyses were used. RESULTS: Twenty-seven patients (mean 39.6, SD 15.0) were included in this study. Overall, the patients were satisfied with the treatment results and the received care. Depressive feelings were negatively associated with satisfaction of treatment results (p = .01) and positively associated with satisfaction of received care (p = .01), while pain intensity was negatively associated with satisfaction of the received care. CONCLUSION: Depressive feelings are a significant negative predictor of patients' satisfaction with the treatment result for TMD pain, while average pain intensity is a significant negative predictor of patients' satisfaction with the received care.

Swallowing performance in older adults: Associated cognitive, neuroanatomical and demographic factors.

BACKGROUND: Swallowing problems are frequently seen in older adults, especially in individuals with cognitive impairment (CI). The brain plays a crucial role in both cognition and swallowing. Using magnetic resonance imaging (MRI) data, researchers identified regions associated with swallowing. However, it is not yet fully elucidated which factors influence the swallowing performance in older adults. OBJECTIVES: The current study investigated which factors, such as cognitive function, neuroanatomical factors (e.g., the cortical thickness and volume of specific brain regions) and demographical factors are associated with swallowing performance in older adults. Secondly, it was investigated whether there is a difference in neuroanatomical factors between individuals with and without CI. RESEARCH DESIGN AND METHODS: In total, 15 CI individuals (73.1 ± 9.1 years; 46.7% male) and 48 non-CI controls (69.0 ± 5.1 years; 29.2% male) were included. The repetitive saliva swallowing test (RSST) was performed, and an MRI scan was acquired from the participants. RESULTS: Multivariate linear regression analysis showed that the cortical thickness of the right supramarginal gyrus and female gender were positively associated, and a higher age was negatively associated with the RSST in older adults (p < .05). CI was not significantly associated with swallowing performance. Furthermore, it was found that the cortical volume differs more frequently between CI and non-CI than the cortical thickness. CONCLUSION: A thinner cortex of the right supramarginal gyrus and being an older female are associated with poorer swallowing performance. Secondly, cortical volume was more often found to differ between CI and non-CI individuals than cortical thickness.

[Treatment of bruxism with botulinum toxin: think twice!] / Behandeling van bruxisme met botulinetoxine: bezint eer ge begint!

A recent publication in the Nederlands Tijdschrift Voor Tandheelkunde (Dutch Journal of Dentistry) suggests botulinum toxin as a primary treatment for bruxism, especially for severe complaints of teeth grinding or jaw clenching. However, in the opinion of Lobbezoo et al., some outdated views on bruxism are used, and botulinum toxin is incorrectly classified as safe, according to them. In this Vision article, the authors describe the current insights into bruxism; they indicate how the presence of bruxism can be assessed in the clinic; when and how bruxism is treated; and finally, what the role of botulinum toxin is: an ultimum refugium. Therefore, regarding the use of botulinum toxin within the discipline of orofacial pain and dysfunction Lobbezoo et al. recommend: think twice!

[A PhD completed. Oral health of people with Parkinson's disease]. / Serie: Hora est. Mondgezondheid van mensen met de ziekte van Parkinson.

Parkinson's disease is a neurodegenerative disease, characterized by motor and non-motor symptoms. Because of the higher prevalence of Parkinson's disease in older adults, the hypothesis was that Parkinson's disease patients would have worse oral health. Since the quality of life deteriorates with Parkinson's disease, it is important to study what the influence of the mouth is in this. The aim of this thesis was to further our knowledge of Parkinson's disease and oral health (oral health and its diseases, and orofacial pain and dysfunction). The overall conclusion was that oral health is worse in patients with Parkinson's disease than in healthy patients, with consequences for Oral Health-Related Quality of Life. Furthermore, it is argued that to overcome disease-related problems, interdisciplinary collaboration is needed. However, because this also brings several difficulties with it, the discussion was initiated that if dental and medical students are more often taught together, a natural collaboration would occur.

[A lifetime of proper chewing: oral health and quality of life]. / Een leven lang goed kauwen: mondgezondheid en levenskwaliteit.

Being able to chew properly is crucial to a good quality of life. This, in turn, is based on good oral health. This not only applies to healthy people, but also to those who are vulnerable. To achieve this good oral health, the authors of this opinion paper argue for more integration of medical and dental education, in order to promote shared expertise and, thus, interprofessional collaboration. It is expected this will ultimately benefit both general health and oral health for everyone.

Is dopaminergic medication dose associated with self-reported bruxism in Parkinson's disease? A cross-sectional, questionnaire-based study.

OBJECTIVES: It is not clear whether dopaminergic medication influences bruxism behaviour in patients with Parkinson's disease (PD). Therefore, the aims are to investigate (i) the prevalence of possible (i.e., self-reported) bruxism (sleep and awake) in PD patients, and (ii) whether the use of dopaminergic medication and other factors (viz., demographic characteristics, PD-related factors, and possible consequences of bruxism) are associated with possible bruxism (sleep or awake). MATERIALS AND METHODS: This study concerns a secondary analysis of an earlier published study. Three hundred ninety-five PD patients (67.9 ± 8.6 years of age; 58.7% males) were included. The levodopa equivalent daily dosage (LEDD) was used as a measure of the dopaminergic medication level. Subsequently, a logistic regression analysis was performed for the dependent variables 'awake bruxism' and 'sleep bruxism', with the following predictors: gender, age, LEDD, time since PD diagnosis, temporomandibular disorder (TMD) pain, jaw locks, and tooth wear. RESULTS: The prevalence of possible awake and sleep bruxism was 46.0% and 24.3%, respectively. Awake bruxism was associated with sleep bruxism (OR = 8.52; 95% CI 3.56-20.40), TMD pain (OR = 4.51; 95% CI 2.31-8.79), and tooth wear (OR = 1.87; 95% CI 1.02-3.43). Sleep bruxism was associated with tooth wear (OR = 12.49; 95% CI 4.97-31.38) and awake bruxism (OR = 9.48; 95% CI 4.24-21.19). Dopaminergic medication dose was not associated with awake bruxism (OR = 1.0; 95% CI 0.99-1.00) or sleep bruxism (OR = 1.0; 95% CI 0.99-1.00). CONCLUSION: Bruxism is a common condition in PD patients, but is not associated with the dopaminergic medication dose. CLINICAL RELEVANCE: (Oral) health care providers should be alerted about the possibility of sleep and awake bruxism activity in PD patients, along with this activity's possible negative health outcomes (viz., TMD pain, tooth wear).

[Early oral symptoms of Parkinson's disease]. / Vroege orale symptomen van de ziekte van Parkinson.

A family dentist established that the oral self-care of a 58-year-old man was suddenly inadequate. The dental hygienist who had been recruited subsequently noticed that the dexterity of the man was inadequate. The man's general medical practitioner referred him to a neurologist, who diagnosed Parkinson's disease. Due to this problematic situation, the man was off the family dentist's radar for approximately 1 year. Thereafter, a course of intensive support for his oral health behaviour was initiated. Given the progressivity of Parkinson's disease, it makes sense to aim at an oral health plan resistant to the patient's life course. The family dentist should be aware of his continuing responsibility to provide care and supervision until such time when informal and professional domiciliary care are no longer satisfactory or achievable and admission to a care facility is unavoidable. Only then can the family dentist hand over his responsibility to the geriatric dentist allied to that specific care facility.

[Series: Medicaments and oral healthcare. Medicaments and addictive substances, potentially inducing or ameliorating bruxism]. / Serie: Medicamenten en mondzorg. Medicamenten en verslavende middelen die potentieel bruxisme induceren of dempen.

Bruxism is described as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. This article provides an inventory of medications registered in the Netherlands and of addictive substances reported to potentially induce or aggravate bruxism as an adverse effect, and of medications registered in the Netherlands reported to potentially ameliorate existing bruxism. Groups of medications known as having the potential adverse effect of bruxism are amphetamines, anticonvulsants and selective serotonin reuptake inhibitors. Separate medicaments found in the scientific literature, having this potential are aripiprazole, atomoxetine, duloxetine, flecainide, ketotifen and methadone. Addictive substances with bruxism as potential adverse effect are alcohol, heroin, methamphetamine, methylenedioxymethamphetamine, nicotine and piperazines. Medications with the potential to ameliorate existing bruxism are botulinum toxin A, bromocriptine, buspirone, clonazepam, clonidine, gabapentin and levodopa.

[Possible treatment options for Parkinson's disease]. / Behandelingsmogelijkheden voor de ziekte van Parkinson.

Possible treatment options for Parkinson's disease consist of medications for motor symptoms as well as non-motor symptoms, such as cognitive decline, depression, hallucinations and delusions, constipation, and drooling. A number of these medications are in the experimental stage. In addition, physical activity and exercise can favourably influence the motor as well as the non-motor symptoms. Speech and dysphagia therapy are available, whereas cognitive behavioural therapy can control depressionand anxiety. Deep brain stimulation is the only surgical treatment currently used. Potential future surgical treatments are gene therapy, (stem) cell therapy, and the application of growth factors. Worldwide, research projects are being carried out in order to be able to control the disease. Once in a while surprising discoveries are made. Whether cure and/or prevention are possible remains to be seen.

[Parkinson's disease, temporomandibular disorders and bruxism: A pilot study]. / De ziekte van Parkinson, temporomandibulaire disfunctie en bruxisme.

Even though bruxism and Parkinson's disease have much in common, a possible relationship between them has not been established. The aim of this study was to gain more insight into a possible relationship between bruxism and temporomandibular disorders on the one hand and Parkinson's disease on the other. For this study, 708 people (368 with Parkinson's disease or parkinsonism and 340 controls) fully completed a questionnaire. The questionnaire included a selective Dutch translation of the questions from the Diagnostic Criteria for TMD (DC/TMD), complemented with a question about tooth wear. The chi-square test and independent samples t test were used for the data analysis. The results showed patients with Parkinson's disease or parkinsonism reported pain resulting from temporomandibular disorders and bruxism when asleep and awake significantly more often than the controls. When facial pain was reported, patients with Parkinson's disease or parkinsonism had a higher mean pain score than the controls. In conclusion, this study showed a relationship between Parkinson's disease or parkinsonism on the one hand and bruxism on the other. Furthermore, the study revealed a relationship between Parkinson's disease or parkinsonism on the one hand and pain resulting from temporomandibular disorders on the other.