Authors :
Afsaneh Taghizadehghasemabadi; Reza Mirzaeiebrahimabadi; Seyedehmahrokh Moosavimordghafari; Seyedeh Hana Hosseini; Alireza Sedaghati Jahromi; Pegah Talebiardekani
Volume/Issue :
Volume 10 - 2025, Issue 11 - November
Google Scholar :
https://tinyurl.com/y5zwn7kk
Scribd :
https://tinyurl.com/4kmzkkx6
DOI :
https://doi.org/10.38124/ijisrt/25nov1566
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 30 to 40 days to display the article.
Abstract :
Stroke is a major cause of long-term disability across the world, requiring thorough rehabilitation strategies. This
review discusses the combination of oral health management and pharmacotherapy in stroke neurorehabilitation. We cover
the neurological basis of stroke recovery, including the concepts of neuroplasticity, mechanisms of motor recovery, and
neuromodulation approaches, as well as the frequently neglected oral health problems associated with stroke survivors,
including dysphagia, poor oral health, and risk of aspiration pneumonia. An interprofessional model between neurologists
and dental professionals is presented as a way to enhance patient outcomes. Evidence shows that the collaborative provision
of oral care can help minimize complications (e.g., pneumonia) and improve quality of life in stroke patients. Key
pharmaceutical therapeutic interventions to improve post-stroke recovery (including neuroplasticity-enhancing drugs) and
their oral health implications are also summarized. The conclusion presents the importance of the role of a neurologist-
dentist to work in a complementary manner, incorporating oral health protocols and judicious pharmacotherapy in order
to help provide optimal rehabilitation outcomes in patients with stroke.
Keywords :
Stroke Rehabilitation, Oral Health, Neuroplasticity, Dysphagia, Interprofessional Collaboration, Pharmacotherapy.
References :
- Feigin, V. L., Brainin, M., Norrving, B., Martins, S. O., Pandian, J., Lindsay, P., F Grupper, M., & Rautalin, I. (2025). World Stroke Organization: Global Stroke Fact Sheet 2025. International journal of stroke : official journal of the International Stroke Society, 20(2), 132–144. https://doi.org/10.1177/17474930241308142
- Cardoso, A. F., Ribeiro, L. E., Santos, T., Pinto, M., Rocha, C., Magalhães, J., Augusto, B., Santos, D., Duque, F. M., Fernandes, B. L., Sousa, R. C., Silva, R., Ventura, F., Fernandes, A. M., Cardoso, D., & Rodrigues, R. (2023). Oral Hygiene in Patients with Stroke: A Best Practice Implementation Project Protocol. Nursing Reports, 13(1), 148-156. https://doi.org/10.3390/nursrep13010016
- Sørensen, R. T., Rasmussen, R. S., Overgaard, K., Lerche, A., Johansen, A. M., & Lindhardt, T. (2013). Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. The Journal of neuroscience nursing: journal of the American Association of Neuroscience Nurses, 45(3), 139–146. https://doi.org/10.1097/JNN.0b013e31828a412c
- Singh, S. (2024). Neuroplasticity and Rehabilitation: Harnessing Brain Plasticity for Stroke Recovery and Functional Improvement. Universal Research Reports, 11(3), 50–56. https://doi.org/10.36676/urr.v11.i3.1287
- Takeuchi, N., & Izumi, S. (2013). Rehabilitation with poststroke motor recovery: a review with a focus on neural plasticity. Stroke research and treatment, 2013, 128641. https://doi.org/10.1155/2013/128641
- Zeiler S. R. (2019). Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon. Current neurology and neuroscience reports, 19(3), 13. https://doi.org/10.1007/s11910-019-0927-x
- Arya, K. N., Pandian, S., Verma, R., & Garg, R. K. (2011). Movement therapy induced neural reorganization and motor recovery in stroke: a review. Journal of bodywork and movement therapies, 15(4), 528–537. https://doi.org/10.1016/j.jbmt.2011.01.023
- Leuchter, B., Pedley, T.A., Lisanby, S.H., Mayberg, H.S. and Schiff, N.D. (2012), Brain stimulation in neurology and psychiatry: perspectives on an evolving field. Annals of the New York Academy of Sciences, 1265: vii-x. https://doi.org/10.1111/j.1749-6632.2012.06740.x
- Cha, S., Choi, J., Moon, C. et al. Non-invasive brain stimulation contributing to postural control with and without stroke: a systematic review and meta-analysis. Sci Rep 15, 26020 (2025). https://doi.org/10.1038/s41598-025-07840-7
- Ting WK-C, Fadul FA-R, Fecteau S and Ethier C (2021) Neurostimulation for Stroke Rehabilitation. Front. Neurosci. 15:649459. doi: 10.3389/fnins.2021.649459
- Dawson, J., Liu, C. Y., Francisco, G. E., Cramer, S. C., Wolf, S. L., Dixit, A., Alexander, J., Ali, R., Brown, B. L., Feng, W., DeMark, L., Hochberg, L. R., Kautz, S. A., Majid, A., O'Dell, M. W., Pierce, D., Prudente, C. N., Redgrave, J., Turner, D. L., Engineer, N. D., … Kimberley, T. J. (2021). Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial. Lancet (London, England), 397(10284), 1545–1553. https://doi.org/10.1016/S0140-6736(21)00475-X
- Stinear C. (2010). Prediction of recovery of motor function after stroke. The Lancet. Neurology, 9(12), 1228–1232. https://doi.org/10.1016/S1474-4422(10)70247-7
- Curtin C , Barrett A , Burke FM , McKenna G , Healy L , Hayes M . Exploring facilitators and barriers associated with oral care for inpatients with dysphagia post-stroke. Gerodontology. 2024; 41: 346-356. doi:10.1111/ger.12709
- Shahi, S., Farhoudi, M., Dizaj, S. M., Sharifi, S., Sadigh-Eteghad, S., Goh, K. W., Ming, L. C., Dhaliwal, J. S., & Salatin, S. (2022). The Link between Stroke Risk and Orodental Status—A Comprehensive Review. Journal of Clinical Medicine, 11(19), 5854. https://doi.org/10.3390/jcm11195854
- Sinha, R. K., Singh, A., Kishor, A., Richa, S., Kumar, R., & Kumar, A. (2021). Evaluation of Oral Hygiene Status in Patients with Hemorrhagic and Ischemic Stroke. Journal of pharmacy & bioallied sciences, 13(Suppl 1), S233–S236. https://doi.org/10.4103/jpbs.JPBS_698_20
- Zalewska, A., Zatoński, M., Jabłonka-Strom, A., Paradowska, A., Kawala, B., & Litwin, A. (2012). Halitosis--a common medical and social problem. A review on pathology, diagnosis and treatment. Acta gastro-enterologica Belgica, 75(3), 300–309.
- Károlyházy, K., Arányi, Z., Hermann, P., Vastagh, I., & Márton, K. (2018). Oral Health Status of Stroke Patients Related to Residual Symptoms: A Case-Control Epidemiological Study in Hungary. Oral health & preventive dentistry, 16(3), 233–239. https://doi.org/10.3290/j.ohpd.a40672
- Corsalini, M., Grassi, R., Di Venere, D., Carella, M., Caprio, S., & Covelli, M. (2004). Riabilitazione protesica di pazienti edentuli con esiti di stroke [Prosthetic rehabilitation of edentulous patients after stroke]. Minerva stomatologica, 53(3), 101–109.
- British Society of Gerodontology (2010). Guidelines for the Oral Healthcare of Stroke Survivors.
- Obana, M., Furuya, J., Matsubara, C., Tohara, H., Inaji, M., Miki, K., Numasawa, Y., Minakuchi, S., & Maehara, T. (2019). Effect of a collaborative transdisciplinary team approach on oral health status in acute stroke patients. Journal of oral rehabilitation, 46(12), 1170–1176. https://doi.org/10.1111/joor.12855
- Uhrin, E., Moldvai, J., Teutsch, B., Domokos, Z., Szabó, B., Hegyi, P., Hermann, P., & Németh, O. (2025). Effect of oral healthcare prevention program on oral hygiene in post-stroke patients: A systematic review and meta-analysis. Journal of dentistry, 154, 105591. https://doi.org/10.1016/j.jdent.2025.105591
- Kim, E. K., Park, E. Y., Sa Gong, J. W., Jang, S. H., Choi, Y. H., & Lee, H. K. (2017). Lasting effect of an oral hygiene care program for patients with stroke during in-hospital rehabilitation: a randomized single-center clinical trial. Disability and rehabilitation, 39(22), 2324–2329. https://doi.org/10.1080/09638288.2016.1226970
- Dai, R., Lam, O. L. T., Lo, E. C. M., Li, L. S. W., & McGrath, C. (2017). A randomized clinical trial of oral hygiene care programmes during stroke rehabilitation. Journal of dentistry, 61, 48–54. https://doi.org/10.1016/j.jdent.2017.04.001
- Cramer S. C. (2015). Drugs to Enhance Motor Recovery After Stroke. Stroke, 46(10), 2998–3005. https://doi.org/10.1161/STROKEAHA.115.007433
- Selim, M. H., & Molina, C. A. (2012). Poststroke treatment with selective serotonin reuptake inhibitors: a journey from sadness to motor recovery. Stroke, 43(11), 3154–3155. https://doi.org/10.1161/STROKEAHA.112.657635
- Su, D., Zhang, Y., Wang, A., Shao, D., Xu, F., Dong, M., Zhao, L., Hu, Y., & Luo, H. (2021). Efficacy and tolerability of selective serotonin reuptake inhibitors on promoting motor recovery after stroke:meta-analysis of randomized controlled trials. Expert review of neurotherapeutics, 21(10), 1179–1189. https://doi.org/10.1080/14737175.2021.1982696
- Chesnais, H., Sloane, K. L., Witsch, J., Favilla, C., Kasner, S. E., & Rothstein, A. (2025). Neurostimulant Use for Rehabilitation and Recovery After Stroke: A Narrative Literature Review. Stroke, 56(7), 1853–1871. https://doi.org/10.1161/STROKEAHA.124.048677
- Lecor Papa Abdou, Kwedi Karl Grégoire, Diatta Mamadou, Dieng Seynabou, Tamba Babacar, et al. (2023). Antihypertensive Medications Inducing Salivary Gland Dysfunction and Xerostomia: A Narrative Review. Advances in Applied Physiology, 8(2), 40-46. https://doi.org/10.11648/j.aap.20230802.12
- Arany, S., Kopycka-Kedzierawski, D. T., Caprio, T. V., & Watson, G. E. (2021). Anticholinergic medication: Related dry mouth and effects on the salivary glands. Oral surgery, oral medicine, oral pathology and oral radiology, 132(6), 662–670. https://doi.org/10.1016/j.oooo.2021.08.015
- Moore, P. A., & Guggenheimer, J. (2008). Medication-induced hyposalivation: etiology, diagnosis, and treatment. Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 29(1), 50–55.
- Cornacchio, A. L., Burneo, J. G., & Aragon, C. E. (2011). The effects of antiepileptic drugs on oral health. Journal (Canadian Dental Association), 77, b140.
- Gallo, C., Bonvento, G., Zagotto, G., & Mucignat-Caretta, C. (2021). Gingival overgrowth induced by anticonvulsant drugs: A cross-sectional study on epileptic patients. Journal of periodontal research, 56(2), 363–369. https://doi.org/10.1111/jre.12828
- Seymour R. A. (1991). Calcium channel blockers and gingival overgrowth. British dental journal, 170(10), 376–379. https://doi.org/10.1038/sj.bdj.4807564
34. Alcázar-Hernández, J. M., Pecci-Lloret, M. R., & Guerrero-Gironés, J. (2024). Oral Manifestations in Patients in Treatment with Antidepressants: A Systematic Review. Journal of clinical medicine, 13(22), 6945. https://doi.org/10.3390/jcm13226945
Stroke is a major cause of long-term disability across the world, requiring thorough rehabilitation strategies. This
review discusses the combination of oral health management and pharmacotherapy in stroke neurorehabilitation. We cover
the neurological basis of stroke recovery, including the concepts of neuroplasticity, mechanisms of motor recovery, and
neuromodulation approaches, as well as the frequently neglected oral health problems associated with stroke survivors,
including dysphagia, poor oral health, and risk of aspiration pneumonia. An interprofessional model between neurologists
and dental professionals is presented as a way to enhance patient outcomes. Evidence shows that the collaborative provision
of oral care can help minimize complications (e.g., pneumonia) and improve quality of life in stroke patients. Key
pharmaceutical therapeutic interventions to improve post-stroke recovery (including neuroplasticity-enhancing drugs) and
their oral health implications are also summarized. The conclusion presents the importance of the role of a neurologist-
dentist to work in a complementary manner, incorporating oral health protocols and judicious pharmacotherapy in order
to help provide optimal rehabilitation outcomes in patients with stroke.
Keywords :
Stroke Rehabilitation, Oral Health, Neuroplasticity, Dysphagia, Interprofessional Collaboration, Pharmacotherapy.