Oral Health Care Services, Barriers and Enablers to Maintaining Good Oral Health in Motor Neurone Disease: A Scoping Review

Abstract

Objectives

The objective of this scoping review was to map existing literature on oral health and related care in individuals with Motor Neurone Disease (MND). Specifically, the review aimed to identify barriers and facilitators to maintaining oral hygiene, summarise available clinical guidelines and patient-facing resources, and examine how oral health care is integrated within multidisciplinary management of MND.

Methods

The review focused on oral health practices without restrictions on language, publication date or study type, excluding studies unrelated to MND or oral health. Data sources included MEDLINE, Embase, CINAHL, and grey literature such as clinical guidelines and patient resources. Screening and data extraction were performed independently by two reviewers to ensure rigor.

Results

Of 847 studies screened, eleven primary studies met the inclusion criteria, comprising case reports, case series, self-reports, cross-sectional studies and letters. The grey literature search identified three clinical guidelines and eight patient information leaflets/resources. The included studies spanned diverse populations, including Amyotrophic Lateral Sclerosis (ALS) patients with varying disease subtypes and care needs, and explored oral hygiene difficulties, care barriers and unique insights from the case studies. Identified gaps highlighted the lack of integration of dental professionals into multidisciplinary care teams. Barriers such as physical limitations, caregiver dependency and limited-service accessibility were prevalent. However, caregiver involvement, multidisciplinary collaboration and innovative solutions like antimicrobial photodynamic therapy and adaptive oral aids emerged as enablers. Poor oral health was strongly associated with increased pain, aspiration pneumonia and diminished well-being, emphasising the need for targeted interventions.

Conclusion

Embedding oral health management within multidisciplinary care frameworks for MND patients, enhancing caregiver training, improving access to dental services and adopting innovative strategies will improve patient outcomes and inform future research.