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Philip P, Prasanna P, Vijaya Remi R, Samuel R, George WT, Joseph MSA, Lim M, Armstrong G, Grills N. Prevalence of dental caries among children and adolescents with intellectual disability in India: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13278. [PMID: 39072860 DOI: 10.1111/jar.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Children with intellectual and developmental disabilities are at a higher risk of developing dental caries. Few scoping reviews have been conducted in India to understand their issues. We aimed to summarise the distribution and risk factors of dental caries among children and adolescents with intellectual disabilities in India. METHODS A scoping review was conducted based on the Arksey O Malley framework. Quality assessment of studies, descriptive and thematic analyses were also conducted. RESULTS We charted, collated, and summarised from four databases. Thirty-one studies met the study criteria consisting of children and adolescents with intellectual disabilities. Median caries prevalence was 70%, decayed missing and fIlled permenant teeth (DMFT) was 2.4, decayed missing and filled decidous teeth (dmft) was 2.36, and DMFS was 3.7. Major determinants were the severity of disability, socioeconomic status and parents' education. Oral care and dental visits were inadequate. CONCLUSION Further exploration is required to improve access and reduce caries experience and prevalence among children with intellectual and developmental disabilities in India.
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Affiliation(s)
- Philcy Philip
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Praveen Prasanna
- Department of Pediatric and Preventive Dentistry, D.A.Pandu Memorial R.V Dental College, Bengaluru, India
| | - Ravi Vijaya Remi
- Department of Pediatric and Preventive Dentistry, D.A.Pandu Memorial R.V Dental College, Bengaluru, India
| | - Reena Samuel
- Community Health Department, Bangalore Baptist Hospital, Bengaluru, India
| | - Willy T George
- Community Health Department, Bangalore Baptist Hospital, Bengaluru, India
| | | | - Mathew Lim
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nathan Grills
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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de Oliveira TN, Drumond VZ, de Arruda JAA, Pani SC, Vargas-Ferreira F, Eustachio RR, Mesquita RA, Abreu LG. Dental caries and developmental defects of enamel in cerebral palsy: A meta-analysis. Oral Dis 2024. [PMID: 38623066 DOI: 10.1111/odi.14957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/16/2024] [Accepted: 03/31/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to compare the occurrence of dental caries and developmental defects of enamel (DDE) in individuals with and without cerebral palsy (CP). MATERIALS AND METHODS We conducted searches across five databases and the grey literature. Data were organized using EndNote 20. Reporting followed the MOOSE checklist. A random-effects model meta-analyses were conducted using RStudio, presenting results as mean difference (MD), odds ratio (OR), and 95% confidence interval (CI). The risk of bias of studies was analyzed using the Newcastle-Ottawa Scale, and the certainty of evidence was assessed using GRADE. RESULTS Among 1336 identified records, 25 studies involving 59,997 participants (mean age: 11.1 years) were included. Data of 12 were pooled into meta-analyses. No significant differences were found between CP and non-CP individuals across indices: DMFT (k = 7) (MD = 0.31; 95% CI [-0.42-1.05]), dmft (k = 4) (MD = 0.31; 95% CI [-0.50-1.14]), DMFS (k = 2) (MD = -0.61; 95% CI [-20.56-19.33]), dmfs (k = 3) (MD = 0.54; 95% CI [-1.09-2.17]), and DDE (k = 3) (OR = 0.80, 95% CI [0.09-7.31]). The certainty of evidence was very low. CONCLUSION Individuals with CP do not appear to differ significantly from those without CP in terms of dental caries experience and DDE.
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Affiliation(s)
| | | | - José Alcides Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sharat Chandra Pani
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Rabelo Eustachio
- Graduate Programme in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Asiri FYI, Tennant M, Kruger E. Oral health of individuals with cerebral palsy in Saudi Arabia: A systematic review. Community Dent Oral Epidemiol 2024; 52:121-129. [PMID: 37855080 DOI: 10.1111/cdoe.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/17/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE This systematic review aimed to comprehensively summarize and critically assess studies conducted on oral health outcomes among individuals with cerebral palsy (CP) in Saudi Arabia. METHODS This study followed the Participants, Exposure, Control and Outcomes (PECO) framework to formulate a focused research question. We conducted an extensive literature search across multiple databases, including PubMed, Medline, Scopus and Embase, in addition to clinical trial registers. Inclusion criteria encompassed clinical studies conducted in either English or Arabic, focusing on CP as defined by the International Classification of Diseases 10 (ICD10), and examining various oral health conditions and parameters. Nonclinical studies, commentaries, other systematic reviews and letters to the editor were excluded. Data extraction included comprehensive information about the study characteristics, oral health outcomes (dental, oral or periodontal disease; changes in standardized indices; dental trauma and other types of oral diseases) and an assessment of the risk of bias using the Appraisal Tool for Cross-Sectional Studies (AXIS). RESULTS The initial search yielded a total of 879 articles, ultimately resulting seven studies that met our stringent inclusion criteria. All of these studies were conducted as cross-sectional investigations in different cities within Saudi Arabia. The sample sizes ranged from 46 to 400 participants, all falling within the age range of 2-18 years. Notably, the prevalence of dental caries among individuals with CP in these studies varied significantly, with rates ranging from 52.9% to as high as 98.6%. Additionally, a substantial portion of CP patients exhibited poor oral hygiene, with figures ranging between 34.6% and 66.2%, and dental trauma was reported in 47.5% of the cases. Moreover, these studies underscored the influence of motor function and intellectual disabilities on the oral health status of CP individuals. Furthermore, various secondary outcomes, including periodontal parameters and oral health-related quality of life, were also assessed. However, it is essential to acknowledge that several sources of bias were identified within these studies, raising questions about the generalisability of their findings. CONCLUSION In conclusion, the systematic review revealed a concerning pattern of high dental caries prevalence and other oral health issues among individuals with CP in Saudi Arabia. Nevertheless, the need for comparative studies between CP patients and those without CP is evident to establish a definitive understanding of the oral health status of CP individuals. Initiating early interventions such as oral hygiene education, preventive dentistry programs, and orthodontic interventions could potentially contribute to improved oral health outcomes for individuals with CP in Saudi Arabia.
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Affiliation(s)
- Faris Yahya I Asiri
- Department of Preventive Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
- International Research Collaboration-Oral Health and Equity, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Marc Tennant
- International Research Collaboration-Oral Health and Equity, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Estie Kruger
- International Research Collaboration-Oral Health and Equity, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
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Kemer SN, Serel-Arslan S. A comparative analysis of oropharyngeal functions in preterm and term children with cerebral palsy. Early Hum Dev 2024; 190:105964. [PMID: 38325005 DOI: 10.1016/j.earlhumdev.2024.105964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
This study aims to compare term and preterm children with Cerebral Palsy (CP) in terms of their oropharyngeal functions. A total of 50 children with CP participated in the study, and were divided into two groups according to their birth history including preterm group (gestational age below 37 weeks; 60 % female; mean age = 6.86 ± 4.35 years) and term group (gestational age between 37 and 41 weeks; 60 % female; mean age = 6.48 ± 4.86 years). Chewing and swallowing functions were evaluated in terms of oropharyngeal functions. Chewing evaluation was performed by using the Karaduman Chewing Performance Scale (KCPS) and the Turkish version of the Mastication Observation and Evaluation Instrument (T-MOE). The pediatric version of the Eating Assessment Tool (PEDI-EAT-10) was used to evaluate swallowing performance of children. In addition, the Behavioral Pediatric Feeding Assessment Scale (BPFAS) was used to assess feeding behaviors of children. There were significant differences between groups in terms of KCPS (p = 0.03), T-MOE (p = 0.01), and PEDI-EAT-10 scores (p = 0.04). There was a significant difference between groups in terms of the parental frequency score from the BPFAS (p = 0.04). Oropharyngeal functions of preterm children with CP were more adversely affected than term children with CP. Clinicians working with children with CP should be aware of the risks of preterm birth on oropharyngeal functions, and take precautions for oropharyngeal dysfunction in the early period in preterm children with CP.
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Affiliation(s)
- Seda Nur Kemer
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkiye; Ondokuz Mayıs University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Samsun, Turkiye.
| | - Selen Serel-Arslan
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkiye
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Tuncay S, Sarman A. The relationship of spiritual orientation and caregiver burden of caregiver mothers with a child with cerebral palsy in Turkey. Child Care Health Dev 2024; 50:e13141. [PMID: 37309022 DOI: 10.1111/cch.13141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study aims to examine the association between spiritual orientation and the caregiving burden experienced by mothers of children with cerebral palsy. METHODS Parents of 181 children with cerebral palsy, aged 0-18, participated in this cross-sectional-descriptive study. "Sociodemographic Form," "Spiritual Orientation Scale," "Zarit Caregiver Burden Scale," and "Gross Motor Function Classification System" were used to collect data. RESULTS The mothers who participated in the study had a mean age of 35.74 ± 5.94 years. The study showed that 17.1% of children with cerebral palsy did not receive special education, and 92.8% of them were born with a disability. Additionally, 62.4% of the children were found to be undernourished, 48.6% had irregular oral care, 43.1% had semi-active activity, 65.7% had irregular sleeping patterns, and 50.8% only partially understood what was stated. The study discovered that as mothers' ages increased, their spiritual orientation decreased, and their burden of caring increased. Furthermore, the mothers of children with severe disabilities had an increasing burden of care, as indicated by the gross motor classification. CONCLUSIONS The study found that mothers with higher spiritual orientation scores perceived less care burden. These findings suggest the need for implementing activities to provide moral support to mothers.
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Affiliation(s)
- Suat Tuncay
- Faculty of Health Science, Department of Pediatric Nursing, Bingol University, Bingol, Turkey
| | - Abdullah Sarman
- Faculty of Health Science, Department of Pediatric Nursing, Bingol University, Bingol, Turkey
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Pansrimangkorn K, Asvanit P, Santiwong B. Factors associated with dental caries experience of Thai preschool children with cerebral palsy. SPECIAL CARE IN DENTISTRY 2023; 43:40-46. [PMID: 35635839 DOI: 10.1111/scd.12732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 01/21/2023]
Abstract
AIM To investigate the factors association with dental caries experience in the primary dentition of Thai preschool children with cerebral palsy. METHODS AND RESULTS A cross-sectional study was conducted among sixty Thai preschool children with cerebral palsy, aged 3-6 years old. Caries experience was determined by identifying decayednon-cavitated and cavitated lesion, missing, and filled surfaces of deciduous teeth(dmfs). Sociodemographic data, CP motor types, dietary habits, oral health behaviors and dental plaque index were collected. Multiple linear regression analysis was carried out to identify the strength of the association between factors and dental caries experience. The prevalence of dental caries was 91.66%. The average dmfs was 20.30 ± 21.63 surfaces/individual. The multiple linear regression indicated that dmfs was significantly associated with snacking carbohydrate between meals more than two times/day (β ± SE = 0.372 ± 0.125; p = 0.004), spastic type of cerebral palsy (β ± SE = 0.309 ± 0.124; p = 0.015) and one-time daily tooth brushing (β ± SE = 0.306 ± 0.124; p = 0.017). CONCLUSIONS Nine out of 10 preschool children with CP experienced dental caries. Spastic type of CP had more risk to develop dental decay. Caries prevention for preschool children with CP should emphasis on controlling the frequency of carbohydrate snack no more than two times/day and reinforcing tooth brushing at least twice daily.
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Affiliation(s)
| | - Pornpun Asvanit
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Busayarat Santiwong
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Cui S, Akhter R, Yao D, Peng XY, Feghali MA, Chen W, Blackburn E, Martin EF, Khandaker G. Risk Factors for Dental Caries Experience in Children and Adolescents with Cerebral Palsy—A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138024. [PMID: 35805684 PMCID: PMC9265822 DOI: 10.3390/ijerph19138024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Cerebral palsy is a developmental motor disorder which has far-reaching impacts on oral health. This scoping review examined the extent of research undertaken regarding the risk factors affecting dental caries experience in children and adolescents with cerebral palsy. Data were obtained from the electronic databases Web of Science and PubMed, using 10 search strings, for studies published between 1983 and 2018. Eligible studies were required to have investigated caries in children under 18 with cerebral palsy, as well as be written in English. 30 papers published were identified for inclusion in the review. These included 23 cross-sectional, 6 case–control, and 1 longitudinal study. Studies were categorized into six domains of risk factors: socioeconomic status (SE); cerebral palsy subtype (CPS); demographics (D); condition of oral cavity (OC); dental habits (DH); nutrition and diet (ND). This review was conducted and reported in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The most significant risk factors were caregiver-related education levels, oral health literacy, and sugar intake; this underlines the important role of special education and dental awareness in reducing dental caries incidence in CP children. Other factors showed divergent findings, highlighting the need for standardization and culturally specific studies in future literature.
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Affiliation(s)
- Sarah Cui
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Rahena Akhter
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
- Correspondence: ; Tel.: +61-2889-04348
| | - Daniel Yao
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Xin-Yun Peng
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Mary-Anne Feghali
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Winnie Chen
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Emily Blackburn
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Elizabeth Fieldja Martin
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia; (S.C.); (D.Y.); (X.-Y.P.); (M.-A.F.); (W.C.); (E.B.); (E.F.M.)
| | - Gulam Khandaker
- Central Queensland Public Health Unit (Rockhampton), Rural and District Wide Service, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia;
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Obeidat R, Noureldin A, Bitouni A, Abdellatif H, Lewis-Miranda S, Liu S, Badner V, Timothé P. Oral health needs of U.S. children with developmental disorders: a population-based study. BMC Public Health 2022; 22:861. [PMID: 35488224 PMCID: PMC9055681 DOI: 10.1186/s12889-022-13237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Background Children with Special Health Care Needs (CSHCN) have higher rates of oral diseases and tooth decay compared with the general population. Children with developmental disorders/ disabilities (DD) are a subset of CSHCN whose oral health has not been specifically addressed. Therefore, this study had two objectives: to describe the oral health needs (OHN) of children with DD compared with children without DD; and to assess barriers to access to care, utilization of dental services, and their association with oral health needs for children with DD. Methods This cross-sectional study utilized a sample of 30,530 noninstitutionalized children from the 2018 National Survey of Children’s Health (NSCH). Analysis was conducted using descriptive and inferential statistics. Results The analysis identified 6501 children with DD and 24,029 children without DD. Children with DD had significantly higher prevalence of OHN (20.3% vs. 12.2%, respectively), unmet dental needs (3.5% vs 1.2%), and utilization of any dental visits (86.1% vs 76.1%), (P-value < . 001). The adjusted logistic model identified four factors that contributed to the higher odds of OHN among children with DD: poverty (< 100% of the Federal Poverty Level (AOR = 2.27, CI: 1.46–3.51), being uninsured (AOR = 2.12, 95% CI: 1.14–3.95), a high level of disability (AOR = 1.89, CI: 1.23–2.78), and living in the western United States (AOR = 1.61, CI: 1.09–2.37. Conclusion Despite higher utilization of dental services, children with DD had poorer oral health and more unmet dental needs than children without DD. Advocacy efforts and policy changes are needed to develop affordable access that assesses, as early as possible, children with DD whose conditions impact their ability a great deal so that their potential OHN may be alleviated more effectively.
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Affiliation(s)
- Raghad Obeidat
- Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA.
| | - Amal Noureldin
- Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Anneta Bitouni
- Department of Comprehensive Dentistry, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Hoda Abdellatif
- Princess Nourah Bint, Abdulrahman University, Riyadh, Saudi Arabia
| | - Shirley Lewis-Miranda
- Department of Comprehensive Dentistry, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Shuling Liu
- Statistical Collaboration Center, Texas A&M University, 155 Ireland Street, College Station, TX, 77843, USA
| | - Victor Badner
- Depts. of Dentistry and Epidemiology and Population Health, Albert Einstein College of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, New York City, NY, 10461, USA
| | - Peggy Timothé
- Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
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Ajwa N, Alhuwayji ZAA, Masiri HM, Alhaddad NM, Allaf LT, AlMutairi AMR, Al-Lwemi N. Prevalence of Dental Defects Among Pediatric Patients with Cerebral Palsy: A Systematic Review. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/djodfvu3os] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Castelo Branco CMC, Cabral GMP, Castro AMGS, Ferreira ACFM, Bonacina CF, Lussi A, Santos MTBR, Diniz MB. Caries prevalence using ICDAS visual criteria and risk assessment in children and adolescents with cerebral palsy: A comparative study. SPECIAL CARE IN DENTISTRY 2021; 41:688-699. [PMID: 34171134 DOI: 10.1111/scd.12621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS To compare the dental caries prevalence using the International Caries Detection and Assessment System (ICDAS) and the caries risk by Caries Management by Risk Assessment (CAMBRA) in individuals with cerebral palsy (CP) and normoactives (NAs). METHODS AND RESULTS Sixty children and adolescents aged 6-12 years (30 CP/30 NA) were clinically evaluated by one calibrated examiner using two-digit ICDAS criteria and converted into components of dmf/DMF indices: d2mf2/D2MF2 (enamel and dentin lesions) and d3mf3/D3MF3 (dentin lesions). An adapted CAMBRA was used for risk classification. The mean d2mf2s/d2mf2t and D2MF2S/D2MF2T for CP were 17.0 ± 16.8/7.5 ± 4.3 and 10.7 ± 17.6/5.3 ± 5.8, respectively, and for NA were 17.2 ± 16.9 /6.9 ± 4.8 and 11.1 ± 11.7/5.5 ± 4.7, respectively. The mean d3mf3s/d3mf3t and D3MF3S/D3MF3T for CP were 10.1 ± 16.7/3.0 ± 4.1 and 4.9 ± 15.6/0.2 ± 0.4, respectively, while for NA the mean values were 9.8 ± 13.0/3.5 ± 3.8 and 2.1 ± 5.7/0.9 ± 2.0, respectively. There were no statistically differences for caries prevalence and risk in both groups (p > 0.05). CONCLUSIONS Dental caries was highly prevalent in CP and NA children and adolescents. Enamel and dentin lesions and high caries risk were the most common condition.
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Affiliation(s)
| | | | | | | | | | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany.,School of Dental Medicine, University of Bern, Switzerland
| | | | - Michele Baffi Diniz
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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Curtis JS, Kennedy SE, Attarha B, Edwards L, Jacob R. Upper Gastrointestinal Disorders in Adult Patients with Intellectual and Developmental Disabilities. Cureus 2021; 13:e15384. [PMID: 34094790 PMCID: PMC8170855 DOI: 10.7759/cureus.15384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The purpose of this literature review is to address the diagnosis and treatment of upper gastrointestinal (GI) disorders in patients with intellectual and developmental disabilities (IDD). Manifestations of upper GI dysmotility and disorders include dysphagia, pulmonary aspiration, malnutrition, gastroesophageal reflux, and gastritis, all of which can impact a person’s quality of life and lead to chronic, life-threatening conditions. This article will explore the existing diagnostic methods and treatments for gastrointestinal disorders as they relate to patients with IDD.
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Affiliation(s)
- Jack S Curtis
- Internal Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Sara E Kennedy
- Internal Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Barrett Attarha
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Linda Edwards
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Rafik Jacob
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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Baumgarten A, Hilgert JB, Rech RS, Cunha-Cruz J, de Goulart BNG. Caries experience in caregiver-intellectual deficient pair: Influence of caregiver's psychological morbidity. SPECIAL CARE IN DENTISTRY 2021; 41:707-715. [PMID: 34057228 DOI: 10.1111/scd.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Evaluate how determinants of psychological morbidity were associated with dental caries experience in the caregiver-intellectual deficient pair. METHODS A cross-sectional study with 299 pair, who had their oral health status assessed using the DMFT index (decayed, missing and filled teeth). Symptoms of anxiety, depression, stress, quality of sleep, and socioeconomic variables were measured in caregivers. Adjusted prevalence ratios were estimated using Poisson regression with the caregiver and children's caries index as outcome. RESULTS The average prevalence of DMFT/dmft was 7.48 (SD ± 3.9) for students with ID and DMFT was 14.7 (SD ± 8.1) for their caregivers. For the caregiver's oral health, the following psychic comorbidities were associated with worse oral health condition: anxiety (PR = 1.48; 95%CI 1.07-2.06), depression (PR = 1.39; 95%CI 1.05-1.85), high level of stress (PR = 1.58; 95%CI 1.17-2.13) and sleep disorders (PR = 1.59; 95%CI 1.18-2.14). For people with ID, the caregiver's psychic comorbidities also showed association with a worse oral health condition, including anxiety (PR = 1.31; 95%CI 1.03-1.74), depression (PR = 1.28; 95%CI 1.01-1.67) and high level of stress (PR = 1.63; 95%CI 1.14-2.32), as well as mother's high level of DMFT (PR = 1.96; 95%CI 1.28-3.03). CONCLUSION Symptoms of depression, anxiety and stress were associated with higher levels of dental caries experience for caregivers and for people with intellectual disabilities.
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Affiliation(s)
- Alexandre Baumgarten
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafaela Soares Rech
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Joana Cunha-Cruz
- School of Dentistry and School of Public Health, University of Washington, Seattle, Washington
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The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9040410. [PMID: 33918280 PMCID: PMC8065439 DOI: 10.3390/healthcare9040410] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/31/2022] Open
Abstract
This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004-2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children's oral health are important to maintain special needs children's oral health.
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14
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Marinkovic N, Zelic K, Milovanovic P, Milutinovic J, Djuric M, Nikodijevic Latinovic A, Nedeljkovic N. Dental age and skeletal maturity assessment in patients with cerebral palsy. Eur J Oral Sci 2021; 129:e12780. [PMID: 33786880 DOI: 10.1111/eos.12780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
The aims of this study were to calculate the estimated dental age and the degree of skeletal maturity in patients with cerebral palsy and control patients (i.e., without a diagnosis of cerebral palsy) and to compare the findings with the chronological age of patients in both study groups. In this cross-sectional study, the European formula and the Willems method were used to estimate the dental age of 52 patients with cerebral palsy and 104 control patients, all aged between 7 and 15 years. For all patients, their estimated dental age was compared with their chronological age. The degree of skeletal maturity of 35 patients with cerebral palsy and 104 control patients was estimated according to Baccetti's method. There was no statistically significant difference in the deviation of the estimated dental age from the chronological age between patients with cerebral palsy and control patients when the European formula or the Willems method was applied. No difference was found in the frequency of Baccetti's stages between patients with cerebral palsy and control patients in the same age category, for both sexes. To estimate dental age in patients with cerebral palsy, the European formula is preferable for orthodontic purposes and the Willems method is preferable for forensic purposes. Using Baccetti's method it was not possible to detect potential differences in skeletal maturity between patients with cerebral palsy and controls.
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Affiliation(s)
- Nemanja Marinkovic
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ksenija Zelic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Milutinovic
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Nenad Nedeljkovic
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Bensi C, Costacurta M, Docimo R. Oral health in children with cerebral palsy: A systematic review and meta‐analysis. SPECIAL CARE IN DENTISTRY 2020; 40:401-411. [DOI: 10.1111/scd.12506] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/22/2020] [Accepted: 08/01/2020] [Indexed: 01/07/2023]
Affiliation(s)
- Caterina Bensi
- Paediatric Dentistry Post‐Graduate School University of Rome “Tor Vergata” Rome Italy
| | - Micaela Costacurta
- Pediatric Dentistry, Department of Surgical Sciences University of Rome “Tor Vergata” Rome Italy
| | - Raffaella Docimo
- Pediatric Dentistry, Department of Surgical Sciences University of Rome “Tor Vergata” Rome Italy
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Cardona‐Soria S, Cahuana‐Cárdenas A, Rivera‐Baró A, Miranda‐Rius J, Martín de Carpi J, Brunet‐Llobet L. Oral health status in pediatric patients with cerebral palsy fed by oral versus enteral route. SPECIAL CARE IN DENTISTRY 2019; 40:35-40. [DOI: 10.1111/scd.12429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Sandra Cardona‐Soria
- Department of Pediatric DentistryHospital Sant Joan de DéuUniversity of Barcelona Barcelona Spain
| | - Abel Cahuana‐Cárdenas
- Department of Pediatric DentistryHospital Sant Joan de DéuUniversity of Barcelona Barcelona Spain
| | - Alejandro Rivera‐Baró
- Department of Pediatric DentistryHospital Sant Joan de DéuUniversity of Barcelona Barcelona Spain
- Hospital DentistryClinical Orthodontics and Periodontal Medicine Research Group (HDECORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD) Barcelona Spain
| | - Jaume Miranda‐Rius
- Department of Pediatric DentistryHospital Sant Joan de DéuUniversity of Barcelona Barcelona Spain
- Hospital DentistryClinical Orthodontics and Periodontal Medicine Research Group (HDECORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD) Barcelona Spain
- Department of OdontostomatologyFaculty of Medicine and Health SciencesUniversity of Barcelona Barcelona Spain
| | - Javier Martín de Carpi
- Comprehensive Care Unit of Pediatric Inflammatory Bowel DiseaseSection of Pediatric Gastroenterology and NutritionHospital Sant Joan de Déu Barcelona Spain
| | - Lluís Brunet‐Llobet
- Department of Pediatric DentistryHospital Sant Joan de DéuUniversity of Barcelona Barcelona Spain
- Hospital DentistryClinical Orthodontics and Periodontal Medicine Research Group (HDECORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD) Barcelona Spain
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Robertson MD, Schwendicke F, de Araujo MP, Radford JR, Harris JC, McGregor S, Innes NPT. Dental caries experience, care index and restorative index in children with learning disabilities and children without learning disabilities; a systematic review and meta-analysis. BMC Oral Health 2019; 19:146. [PMID: 31307444 PMCID: PMC6632188 DOI: 10.1186/s12903-019-0795-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 05/22/2019] [Indexed: 02/07/2023] Open
Abstract
Background Children with learning disabilities (CLD) have worse health outcomes than children with no learning disabilities (CNLD). This systematic review compared caries experience and met dental care need for CLD to CNLD using Decayed, Missing, Filled Permanent Teeth (DMFT) and decayed, missing/extracted, filled primary teeth (dmft/deft), care index (CI), and restorative index (RI) values. Methods Without date or language restrictions four databases were searched for; cross-sectional studies comparing caries experience and CI/ RI in CLD matched to groups of CNLD. Screening and data extraction were carried out independently and in duplicate. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were carried out (random effects model). Results There were 25 articles with 3976 children (1 to 18 years old), from 18 countries, fitting the inclusion criteria. Children with; Down syndrome were investigated in 11 studies, autism in 8 and mixed learning disabilities in 6. The overall mean DMFT for CLD was 2.31 (standard deviation±1.97; range 0.22 to 7.2) and for CNLD was 2.51 (±2.14; 0.37 to 4.76). Using standardised mean difference (SMD), meta-analysis showed no evidence of a difference between CLD and CNLD (n = 16 studies) for caries experience (SMD = -0.43; 95%CI = -0.91 to 0.05). This was similar for sub-groups of children with autism (SMD = -0.28; 95%CI = 1.31 to 0.75) and mixed disabilities (SMD = 0.26; 95%CI = -0.94 to 1.47). However, for children with Down syndrome, caries experience was lower for CLD than CNLD (SMD = -0.73; 95%CI = -1.28 to − 0.18). For primary teeth, mean dmft/deft was 2.24 for CLD and 2.48 for CNLD (n = 8 studies). Meta-analyses showed no evidence of a difference between CLD and CNLD for caries experience across all disability groups (SMD = 0.41; 95% CI = -0.14 to 0.96), or in sub-groups: Down syndrome (SMD = 0.55; 95%CI- = − 0.40 to 1.52), autism (SMD = 0.43; 95%CI = -0.53 to 2.39) and mixed disabilities (SMD = -0.10; 95%CI = -0.34 to 0.14). The studies’ risk of bias were medium to high. Conclusion There was no evidence of a difference in caries levels in primary or permanent dentitions for CLD and CNLD. This was similar for learning disability sub-groups, except for Down syndrome where dental caries levels in permanent teeth was lower. Data on met need for dental caries was inconclusive. Trial registration The protocol was published in PROSPERO: CRD42017068964 (June 8th, 2017). Electronic supplementary material The online version of this article (10.1186/s12903-019-0795-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mark D Robertson
- School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HR, UK.
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - John R Radford
- School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HR, UK
| | - Jenny C Harris
- Community & Special Care Dentistry and Paediatric Dentistry, Charles Clifford Dental Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Scott McGregor
- Dundee University Library, University of Dundee, Dundee, UK
| | - Nicola P T Innes
- School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HR, UK
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Mota-Veloso I, Ramos-Jorge ML, Homem MA, Pordeus IA, Paiva SM, Oliveira-Ferreira F. Dental caries in schoolchildren: influence of inattention, hyperactivity and executive functions. Braz Oral Res 2018; 32:e52. [PMID: 29898021 DOI: 10.1590/1807-3107bor-2018.vol32.0052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 05/03/2018] [Indexed: 11/22/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven's Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother's schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.
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Affiliation(s)
- Isabella Mota-Veloso
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Maria Letícia Ramos-Jorge
- Universidade Federal dos Vales do Jequitinhonha e Mucuri - UFVJM, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Diamantina, MG, Brazil
| | - Marcio Alexandre Homem
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Isabela Almeida Pordeus
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Saul Martins Paiva
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Fernanda Oliveira-Ferreira
- Universidade Federal de Juiz de Fora (UFJF), Department of Basic Sciences, Governador Valadares, MG, Brazil
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Ruiz LA, Diniz MB, Loyola-Rodriguez JP, Habibe CH, Garrubbo CC, Santos MTBR. A controlled study comparing salivary osmolality, caries experience and caries risk in patients with cerebral palsy. Med Oral Patol Oral Cir Bucal 2018; 23:e211-e215. [PMID: 29476677 PMCID: PMC5911353 DOI: 10.4317/medoral.22135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/12/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is a permanent neurological disorder accompanied by secondary musculoskeletal masticatory disorder, with repercussion on chewing and deglutition functions. In these conditions, the liquids ingestion is compromised resulting in salivary osmolality alteration. The objective of this study was to compare salivary osmolality, caries experience and caries risk between normoreactive individuals and patients with CP. MATERIAL AND METHODS The participants were 4-20 years old: 52 patients with CP treated at a reference rehabilitation centre (study group, SG), and 52 normoreactive individuals (control group, CG). Saliva was collected for five minutes using cotton rolls. Following centrifugation, salivary osmolality was determined by freezing point depression osmometry. Evaluations included caries experience (DMFT index), and caries risk based on a caries-risk assessment tool (CAT). Descriptive and inferential statistics (Chi square and Student t tests) were used to compare the groups. Receiver operating characteristic (ROC) analyses were performed and the area under the ROC curve (Az) was calculated. The level of significance was set at 5%. RESULTS The groups were homogeneous for sex (p=0.843) and age (p=0.128). In the SG, spastic type CP was the most prevalent (80.8%), and patients showed significantly higher salivary osmolality values compared with the CG (p<0.001). No significant differences in caries experience (p=0.159) or caries risk (p=0.297) were observed. ROC curve analysis determined a salivary osmolality cutoff point of >74 for the SG and >54 for the CG in the presence of dental caries. A significant correlation was verified between salivary osmolality and the DMFT index for the SG (p≤0.05). CONCLUSIONS Although patients with CP showed higher salivary osmolality values, higher caries experience and caries risk were not observed compared with normoreactive individuals.
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Affiliation(s)
- L-A Ruiz
- Universidade Cruzeiro do Sul, School of Dentistry, Department of Patients with Special Needs, Rua Constantino de Sousa, 454, apto 141, ZIPCODE: 04605-001 São Paulo, SP, Brazil,
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Zhou N, Wong HM, Wen YF, Mcgrath C. Oral health status of children and adolescents with intellectual disabilities: a systematic review and meta-analysis. Dev Med Child Neurol 2017. [PMID: 28627071 DOI: 10.1111/dmcn.13486] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To compare the oral health status of children and adolescents affected by intellectual disabilities with their unaffected counterparts. METHOD Citations published in English were searched from electronic databases (PubMed, Embase, Web of Science, and Scopus) from their start dates to March 2017. The whole process was conducted following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The PICO (population, intervention/interest, comparator, outcome) principle was used to formulate the topic. Studies were synthesized through qualitative summary or, whenever possible, meta-analysis. RESULTS The initial search yielded 2393 records. Thirty-nine studies from 22 countries were identified for qualitative analysis; 26 studies were eligible for meta-analysis. Participants with intellectual disabilities had higher levels of dental plaque, worse gingival status, fewer decayed and filled permanent teeth, and similar caries experience between males and females. These findings were supported by both qualitative and quantitative analysis. Various patterns of caries experiences were indicated by qualitative analysis, but it was not substantiated by meta-analysis. INTERPRETATION There is increasing worldwide interest in oral health status of children with intellectual disabilities. Differences in dental plaque deposition, gingival inflammation, and the number of decayed and filled permanent teeth were investigated between children and adolescents with and without intellectual disabilities. Evidence remains elusive about the pattern of caries experience among those children.
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Affiliation(s)
- Ni Zhou
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Hai Ming Wong
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Yi Feng Wen
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Colman Mcgrath
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Santos MTBR, Diniz MB, Guaré RO, Ferreira MCD, Gutierrez GM, Gorjão R. Inflammatory markers in saliva as indicators of gingival inflammation in cerebral palsy children with and without cervical motor control. Int J Paediatr Dent 2017; 27:364-371. [PMID: 27785840 DOI: 10.1111/ipd.12270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIM To evaluate the relation among gingival inflammation, salivary osmolality, levels of IL-1β, IL-6, IL-8, TNF-α, and s-IgA concentrations in children with spastic CP with or without cervical motor control in a cross-sectional study. DESIGN Unstimulated whole saliva and the gingival index were collected in 37 and 34 CP children with and without cervical motor control, respectively. The data were dichotomized as follows: (=0) absence of gingival inflammation and (≥0.1) presence of gingival inflammation. RESULTS The group without cervical control presented statistically higher mean values of salivary osmolality, s-IgA, and cytokines. In addition, statistically positive correlation between the gingival index and salivary cytokines was observed in the group with cervical control. Salivary osmolality, salivary cytokines, and s-IgA from both groups presented a significant positive correlation. Significant differences (P = 0.00336) in the values of salivary osmolality were observed between the CP individuals with (93.9 ± 32.7) and without gingival inflammation (74.4 ± 16.6). ROC analysis was performed, and values of salivary osmolality >80 indicated a sensitivity of 0.54 and a specificity of 0.79. CONCLUSIONS Children without cervical motor control presented a more pronounced oral inflammatory status that was characterized by higher levels of cytokines.
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Affiliation(s)
| | | | | | | | | | - Renata Gorjão
- Postgraduate Interdisciplinary Program in Health Sciences, Institute of Physical Activity Sciences and Sports, Cruzeiro do Sul University, São Paulo, SP, Brazil
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Santos MTBR, Ferreira MCD, Guaré RO, Diniz MB, Rösing CK, Rodrigues JA, Duarte DA. Gingivitis and salivary osmolality in children with cerebral palsy. Int J Paediatr Dent 2016; 26:463-470. [PMID: 26726753 DOI: 10.1111/ipd.12220] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate the influence of salivary osmolality on the occurrence of gingivitis in children with cerebral palsy (CP). DESIGN A total of 82 children with spastic CP were included in this cross-sectional study. Oral motor performance and gingival conditions were evaluated. Unstimulated saliva was collected using cotton swabs, and salivary osmolality was measured using a freezing point depression osmometer. Spearman's coefficient, receiver operating characteristic (ROC), and multiple logistic regression analyses were performed. RESULTS Strong correlation (r > 0.7) was determined among salivary osmolality, salivary flow rate, visible plaque, dental calculus, and the occurrence of gingivitis. The area under the ROC to predict the influence of salivary osmolality on the occurrence of gingivitis was 0.88 (95% CI 0.81-0.96; P < 0.001). The cutoff value of 84.5 for salivary osmolality presented good sensitivity and specificity, both higher than 77%. The proportion of children presenting salivary osmolality ≤84.5 mOsm/kgH2 O and gingivitis was 22.5%, whereas for the group presenting osmolality >84.5 mOsm/kgH2 O, the proportion of children with gingivitis was 77.5%. Salivary osmolality above 84.5 increased the likelihood of gingivitis fivefold, whereas each additional 0.1 mL of salivary flow reduced the likelihood of gingivitis by 97%. CONCLUSION Gingivitis occurs more frequently in children with CP showing increased values of salivary osmolality.
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Affiliation(s)
| | | | - Renata Oliveira Guaré
- Pediatric Dentistry, Institute of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | - Michele Baffi Diniz
- Pediatric Dentistry, Institute of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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Krekmanova L, Hakeberg M, Robertson A, Braathen G, Klingberg G. Perceived oral discomfort and pain in children and adolescents with intellectual or physical disabilities as reported by their legal guardians. Eur Arch Paediatr Dent 2016; 17:223-30. [DOI: 10.1007/s40368-016-0231-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/15/2016] [Indexed: 12/01/2022]
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Ferraz NKL, Tataounoff J, Nogueira LC, Ramos-Jorge J, Ramos-Jorge ML, Pinheiro MLP. Mechanical control of biofilm in children with cerebral palsy: a randomized clinical trial. Int J Paediatr Dent 2015; 25:213-20. [PMID: 25200983 DOI: 10.1111/ipd.12132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dental biofilm removal is difficult and can be ineffective in individuals with cerebral palsy. OBJECTIVE Determine the effectiveness of brushing with an electric toothbrush on and off in comparison with manual brushing for the removal of biofilm in children aged four to 16 years with cerebral palsy. METHODS A crossover, randomized, simple-blind, clinical trial was conducted. The examiner was blinded to the brushing method (G1: manual; G2: electric toothbrush on; and G3: electric toothbrush off). The order was determined randomly. The participants (n = 40) were examined before and after brushing performed by caregivers using the Turesky-Quigley-Hein biofilm index. Statistical analysis involved the paired t-test, Wilcoxon, Kruskal-Wallis, and anova tests. RESULTS Biofilm was significantly reduced with the three brushing methods (P < 0.001) (mean reductions: 47.6% in G1; 47.4% in G2; 44.5% in G3). Significant differences were found between G1 and G3 (P < 0.001) and between G2 and G3 (P = 0.007). No significant difference was found between G1 and G2 (P = 0.06). CONCLUSION All methods reduced biofilm. Effectiveness was similar between manual brushing and with the electric toothbrush on, whereas both these methods achieved better results in comparison with the electric toothbrush switched off.
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Affiliation(s)
- Nayara Kelly Lyrio Ferraz
- School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
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Albertsen A. Tough luck and tough choices: applying luck egalitarianism to oral health. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2015; 40:342-62. [PMID: 25870307 DOI: 10.1093/jmp/jhv001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Luck egalitarianism is often taken to task for its alleged harsh implications. For example, it may seem to imply a policy of nonassistance toward uninsured reckless drivers who suffer injuries. Luck egalitarians respond to such objections partly by pointing to a number of factors pertaining to the cases being debated, which suggests that their stance is less inattentive to the plight of the victims than it might seem at first. However, the strategy leaves some cases in which the attribution of individual responsibility is appropriate (and so, it seems, is asking people to pick up the tab for their choices). One such case is oral health or significant aspects of this. It is appropriate, the paper argues, to hold people responsible for a number of factors that affect their oral health. A luck egalitarian approach inspired by John Roemer can assess whether people have acted responsibly by comparing their choices to those of their peers. A luck egalitarian approach to oral health would recommend prioritizing scarce resources in a responsibility-weighted queuing system and include copayment and general taxation among its measures of financing.
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Campos PHD, Andrade RSL, Rojas PL, Ferreira MCD, Santos MTBR, Guaré RDO, Diniz MB. Avaliação da microdureza do esmalte de dentes decíduos de crianças com paralisia cerebral. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: Em indivíduos com paralisia cerebral, ocorre redução do fluxo salivar, o que pode predispor à hipomineralização do esmalte e à cárie dentária. OBJETIVO: Comparar a microdureza do esmalte de dentes decíduos anteriores e posteriores de crianças com paralisia cerebral (PC) e crianças normorreativas (NR). MATERIAL E MÉTODO: Foram utilizados 58 dentes decíduos esfoliados/extraídos, que foram distribuídos em quatro grupos: (A) anteriores de PC (n=14); (B) anteriores de NR (n=16); (C) posteriores de PC (n=14), e (D) posteriores de NR (n=14). Os dentes foram seccionados, incluídos em resina acrílica, lixados e polidos. A análise da microdureza longitudinal foi realizada em microdurômetro com endentador do tipo Knoop, com carga estática de 25 g/f e tempo de 5 segundos. Foram realizadas três fileiras de 12 endentações, distanciadas entre si em 100 mm, com profundidade entre 10 e 180 mm. Foram obtidas as médias de cada profundidade para cada dente e, posteriormente, as médias de cada profundidade para cada grupo avaliado. O teste estatístico empregado foi o de Mann-Whitney (α=5%). RESULTADO: As médias de microdureza foram 253,5 ± 55,3 (A), 247,6 ± 45,7 (B), 284,4 ± 68,7 (C) e 252,2 ± 53,8 (D). Não houve diferença estatisticamente significante entre os grupos A e B e os grupos C e D, para cada profundidade e para a média global (p>0,05). CONCLUSÃO: Pôde-se concluir que a microdureza de esmalte de dentes decíduos anteriores e posteriores de crianças com PC foi semelhante à microdureza de esmalte de dentes decíduos de crianças normorreativas.
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Impact of oral health behaviors on dental caries in children with intellectual disabilities in Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11015-27. [PMID: 25340906 PMCID: PMC4211020 DOI: 10.3390/ijerph111011015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/15/2014] [Accepted: 10/16/2014] [Indexed: 11/21/2022]
Abstract
Dental care is consistently reported as one of the primary medical needs of children with disabilities (IDC). The aim of the present study was to explore the influence of oral health behaviors on the caries experience in children with intellectual disabilities in Guangzhou, China. A cross-sectional study was carried out in 477 intellectually disabled children, 12 to 17 years old, who were randomly selected from special educational schools in Guangzhou. A self-administered parental questionnaire was used to collect data on socio-demographic characteristics and oral health behavior variables, and 450 valid questionnaires were returned. Multiple regression analysis was used to examine the factors associated with dental caries. The average age of those in the sample was 14.6 years (SD = 1.3), 68.4% of whom were male, and the caries prevalence rate was 53.5% (DMFT = 1.5 ± 2.0). The factors significantly affecting the development of dental caries in IDC included gender, the presence or absence of cerebral palsy, and the frequency of dental visits and toothbrushing. In conclusion, the presence of cerebral palsy contributed to an increase risk of caries experience in intellectually disabled children, while toothbrushing more than twice a day and routine dental visits were caries-protective factors. Oral health promotion action may lead to a reduction in dental caries levels in IDC.
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Norderyd J, Lillvist A, Klingberg G, Faulks D, Granlund M. Oral health, medical diagnoses, and functioning profiles in children with disabilities receiving paediatric specialist dental care – a study using the ICF-CY. Disabil Rehabil 2014; 37:1431-8. [DOI: 10.3109/09638288.2014.964374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sabuncuoglu FA, Özcan E. Orthodontic management of a patient with cerebral palsy: six years follow-up. J Contemp Dent Pract 2014; 15:491-5. [PMID: 25576118 DOI: 10.5005/jp-journals-10024-1567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM Cerebral palsy (CP) is a disorder that affects muscle tone, movement and motor skills. CP can also lead to other health issues, including vision, hearing and speech problems, as well as learning disabilities and dental problems. A case report describing the successful orthodontic treatment of a 10-year-old boy with the dyskinesia type of CP and severe malocclusion is presented. MATERIALS AND METHODS A 10-year and 2-month old boy was presented by his parents for orthodontic treatment, complaining of his unsatisfactory occlusion and poor chewing efficacy. An extraoral examination showed a convex profle. An intraoral examination showed the patient to be in mixed dentition with a class II molar relationship, 10 mm overjet and 4 mm overbite. In addition, his maxillary and mandibular arches were severely crowded. Cephalometric analysis indicated a severe skeletal class II discrepancy, which was confrmed by an ANB of 12°. The frst phase of treatment involved the use of twin blocks with a headgear tube to attempt some growth modification and reduce the overjet. Once it was clear that the appliance was being well tolerated and the oral hygiene was satisfactory, the fxed appliance was used. RESULTS Because of the good participation of the patient and his parents, orthodontic treatment was successful in the patient, achieving a normal overjet in combination with successful orofacial therapy. CONCLUSION As demonstrated in our case report, the success of the treatment was dependent on the cooperation of the patient and his parents. Furthermore, this case illustrates the importance of the treatment by a dental team in patients with CP.
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Affiliation(s)
- Fidan Alakus Sabuncuoglu
- Orthodontist, Department of Orthodontics, Marasal Çakmak Military Hospital Dental Center, Turkey, e-mail:
| | - Erkan Özcan
- Periodontologist, Department of Orthodontics, Marasal Çakmak Military Hospital Dental Center, Turkey
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Santos MTBR, Ferreira MCD, Mendes FM, de Oliveira Guaré R. Assessing salivary osmolality as a caries risk indicator in cerebral palsy children. Int J Paediatr Dent 2014; 24:84-9. [PMID: 23551764 DOI: 10.1111/ipd.12030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Salivary osmolality reflects the hydration status of individuals with cerebral palsy (CP) necessary for an adequate unstimulated salivary flow rate. AIM To investigate whether salivary osmolality could serve as a potential indicator of caries risk in children with spastic CP by displaying a stronger association with caries occurrence than salivary flow rate. DESIGN The convenience sample consisted of 65 children with CP aged 6-13 years old. Unstimulated whole saliva was collected using cotton roll, and salivary osmolality was measured using a freezing point depression osmometer. The children's oral motor performance was evaluated during the feeding process using the Oral Motor Assessment Scale. Caries occurrence was also evaluated according the World Health Organization criteria. RESULTS Motor skills were significantly associated with caries experience. Regarding the salivary parameters, osmolality presented a stronger association with caries experience than did the salivary flow rate. Children with worse oral motor performance presented a higher rate of caries occurrence. CONCLUSION Osmolality exhibited a stronger association with caries occurrence than did salivary flow rate. This parameter, therefore, could be a potential caries risk indicator for spastic cerebral palsy children.
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Santos MTBR, Guaré RDO, Diniz MB, Ferreira MCD. Experiência de cárie e osmolaridade salivar em crianças com paralisia cerebral. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000600009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Estudos têm demonstrado que quanto maior a severidade do dano neurológico em crianças com paralisia cerebral (PC), maior é o risco de doenças orais. OBJETIVO: Correlacionar a experiência de cárie com a osmolaridade salivar em crianças com PC. MATERIAL E MÉTODO: Participaram do estudo 99 crianças (9,2±2,3 anos) com PC, em tratamento reabilitacional. A saliva de repouso foi coletada no período matutino, utilizando rolos absorventes (Salivette®) por cinco minutos. A osmolaridade salivar foi medida por depressão do ponto de congelamento em osmômetro. As avaliações incluíram a experiência de cárie pelo índice de dentes cariados, perdidos e obturados (CPOD), e o motor oral durante o processo de alimentação da criança. Foram utilizados os testes Qui-quadrado, t de Student, Correlação de Spearman e razão de chances (OR), com nível de significância de 5%. RESULTADO: O grupo 1 (G1) foi composto por 41 crianças livres de cárie e o grupo 2 (G2), por 58 crianças com cárie (CPOD=3,5±2,7). Os grupos foram homogêneos para gênero (p=0,884) e idade (p=0,174). Entretanto, diferiram significantemente com relação à motricidade oral, apresentando G2 maiores porcentagens de crianças com motor oral subfuncional (p<0,001) e tetraparéticos (p=0,001). O G2 apresentou valores significantemente maiores (p<0,001) para osmolaridade (99,6±36,7mOsml) quando comparado ao G1 (76,7±15,9mOsml). Observou-se uma correlação significante entre osmolaridade e experiência de cárie (p<0,001). Apresentar osmolaridade superior a 76,7 (OR=5,18; 1,85 a 14,83) foi determinante individual de maior probabilidade de apresentar risco de cárie (CPOD>0). CONCLUSÃO: Maiores valores de osmolaridade salivar aumentam o risco de cárie em crianças com PC.
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Dourado M, Andrade PMO, Ramos-Jorge ML, Moreira RN, Oliveira-Ferreira F. Association between executive/attentional functions and caries in children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:2493-2499. [PMID: 23751295 DOI: 10.1016/j.ridd.2013.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/23/2013] [Accepted: 05/02/2013] [Indexed: 06/02/2023]
Abstract
The aim of the present study was to evaluate the existence of an association between attention/executive functions and the development of dental caries in individuals with cerebral palsy (CP). Seventy-six children with CP were selected from a physical rehabilitation center and a school serving children with disabilities. The control group was made up of 89 children without neurological impairment. Socioeconomic status, presence of teeth with cavities due to caries, degree of motor impairment and intellectual, executive and attentional functions were assessed. Mean age of participants was 8.9 years (SD=3.56). The CP group had a significantly lower performance (p<0.05, Mann-Whitney test) on the intelligence, attentional function and executive function tests in comparison to the control group. Controlling for the clinical diagnosis (CP or control group), motor impairment and intellectual function, the significant explanatory variables for the presence of teeth with cavities were performance on the Complex Rey figure test (OR=0.941) and the Digit Span subtest of the Wechsler Intelligence Scale for Children in backward order (OR=0.581). After controlling for intellectual function, clinical diagnosis and motor impairment, deficits in executive and attentional functions increased the odds of developing dental caries in children with cerebral palsy.
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Affiliation(s)
- M Dourado
- Departament of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri - UFVJM, Diamantina, MG 39100-000, Brazil.
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