Satisfaction of patients with amyotrophic lateral sclerosis with an oral appliance for managing oral self-biting injuries and alterations in their masticatory system: A case-series study

Statement of problem

About 10% of patients with amyotrophic lateral sclerosis (ALS) are candidates for oral treatment specifically because of traumatic injuries in the lips, cheeks, or tongue due to self-biting. However, patients with ALS have a prevalence of temporomandibular disorder (TMD) similar to that in the general population.

Purpose

The purpose of this case-series study was to determine the degree of satisfaction of patients with ALS with an oral appliance for managing oral self-biting lesions or symptoms related to TMDs. This study also assessed the degree of improvement of the chief complaint and the compliance with and adverse effects of this treatment.

Material and methods

Eleven patients with ALS who sought oral treatment because of oral self-biting or TMD-related symptoms were included. A custom complete-coverage acrylic resin device was fabricated and fitted to each participant. A follow-up visit was planned for 3 months after the placement of the oral appliance, at which point the patients would rate the degree of improvement or worsening of the chief complaint and their degree of satisfaction with the treatment. A 1-sample t test was used to assess whether the degree of improvement of the chief complaint was significant.

Results

Participants reported a mean of 61% (95% confidence interval [CI] 38% to 84%) improvement of the chief complaint and a mean of 84% (95% CI 72% to 97%) satisfaction with the treatment. The mean rate of compliance was 62% (95% CI 40% to 84%) of the recommended time, and only a few adverse effects were reported.

Conclusions

Participants with ALS were highly satisfied with the use of an oral appliance to manage oral self-biting or TMD-related symptoms. Adherence to this treatment was high, and no major adverse effects were observed.