There are many oral and dental problems in patients with progressive muscular dystrophy (PMD). Oropharyngeal muscular dysfunction causes carp mouth, limited mouth opening, reduced masticatory force, contracture or luxation of temporomandibular joint, incomplete velopharyngeal closure, dysphagea and so on. Structural abnormalities such as macroglossia, tongue atrophy, odontoparallaxis, and open bite, high arched palate are also frequently observed. These abnormalities are variable according to the type of PMD and onset of the diseases. Many disabilities and life-threatening risks are derived from these problems. Feeding difficulty, dysphagea, dysarthria, increased risk of choking, decreased effect of non-invasive ventilation due to air leak from open mouth, and difficulties of suction and airway management in resuscitation are such examples. Inefficient oral care induced by motor dysfunction, macroglossia, limited mouth opening raises the risks of dental plaque, caries, preodontitis and aspiration pneumonia. When disabled patients receive odontotherapy, many barriers exist in terms of access by the dentist. Keeping proper position during treatment is often impossible for these patients because of deformities or truncal dysfunction. Approach to a lesion is sometimes blocked by macroglossia, limitation of mouth opening. Monitoring and preparation of cardiopulmonary resuscitation are required in treatment of high risk patients with swallowing dysfunction, respiratory failure and cardiac failure, because there have been certain incidences of dysphagea, choking, acute deterioration of respiratory condition, and arrhythmia induced by epinephrine contained in anesthetics. The impact of oral and dental problems in quality of life and prognosis has been growing since life expectancies have been prolonged by progress in respiratory and infectious controls. However attention to these problems has not been sufficient. Proper managements of oral care, rehabilitation, and treatments, can lead to improvements in dealing with these problems. The cooperation of medical and dental experts is important to obtain good results.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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