Almost 400,000 Canadians live with some sort of long-term disability caused by stroke. And while it's common to think of stroke victims as having muscle paralysis, memory loss or trouble speaking, a stroke can impact oral health, too.
When a patient has a stroke, blood flow to the brain is cut off or dramatically reduced. This can happen from a blood clot or the rupture of an important artery, but the results are the same: reduced brain function. In some patients, the damage makes oral care much more difficult -- especially for denture wearers. There are three main issues that many patients may experience:
Paralysis on one side is a common side effect of having a stroke, and this difficulty with movement can impact the person's ability to adequately open, rinse or clean the mouth.
Without being able to easily open the mouth, denture removal may be more difficult. Caregivers, faced with many other health issues to be concerned about, may not pay suitable attention to denture removal and cleaning on a regular basis. Patients who do regain some motor function may not be able to reach areas of the mouth for thorough cleaning.
Some stroke patients are given medications designed to help blood flow, but these can create two problems for denture wearers.
The first is that blood thinning medications tend to make the patient bleed more easily. Dental exams and procedures can result in large wounds that bleed profusely and are slow to heal, but even routine denture removal and insertion is more likely to produce small cuts or scrapes that bleed. This makes careful denture care much more critical and requires special attention to routine maintenance.
Second, some stroke victims' medicines cause dry mouth as a side effect. Reduced saliva flow impacts dental health and harms the gums. Patients with dentures may have trouble keeping implants in place as periodontal disease causes pockets to form around previously healthy implanted posts where partial dentures are attached. Even the use of saliva substitutes may not stop the problem.
Another issue that can crop up is changes to the patient's mouth. One small study of stroke patients who wore dentures before their stroke found that 42.4 percent needed their denture to be remade. Another 27.3 percent needed their dentures to be rebased or reworked to fit correctly after the stroke.
Patients who have a stroke do have numerous health concerns, but oral health should not be put on the back burner, especially for denture wearers. Stroke patients may need to have frequent professional dental and denture cleanings and have their dentures' fit checked on a regular basis.