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Aburahma SK, Mhanna A, Al-Mousa S, Al-Nusair J, Al Habashneh R. Dental health status and hygiene in children with cerebral palsy: A matched case-control study. Int J Paediatr Dent 2021; 31:752-759. [PMID: 34022090 DOI: 10.1111/ipd.12799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Children with cerebral palsy (CP) are at risk for oral pathology and parafunctional habits, and are reliant on caregivers for oral hygiene. AIM To evaluate oral hygiene habits and oral examination findings among a group of children with CP and a healthy age- and gender-matched control group. DESIGN A comparative, cross-sectional study, consisting of a questionnaire component and a standard dental examination component, each applied to both groups. RESULTS Eighty-three children with CP and 84 healthy children were included. Parents of children with CP were more likely to be of low educational level and lack a professional line of occupation (P < .05). Children with CP were less likely to be responsible for oral hygiene maintenance, adhere to toothbrushing, or receive procedural dental care (P < .001). Food packing and drooling were significantly more likely in children with CP. Malocclusion type III was more prevalent among children with CP, as was higher gingival index and gingival enlargement index-horizontal component (P < .001). There were no differences in caries experience between the CP and control groups. CONCLUSIONS Children with CP have suboptimal oral hygiene habits, limited access to procedural dental care, higher parafunctional habits, and increased periodontal pathology.
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Affiliation(s)
| | | | - Saba Al-Mousa
- Jordan University of Science and Technology, Irbid, Jordan
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Lansdown K, Irving M, Mathieu Coulton K, Smithers-Sheedy H. A scoping review of oral health outcomes for people with cerebral palsy. SPECIAL CARE IN DENTISTRY 2021; 42:232-243. [PMID: 34706111 DOI: 10.1111/scd.12671] [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: 09/11/2021] [Accepted: 10/10/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Good oral health is important for good overall health. Studies have reported poorer oral health outcomes for people with cerebral palsy, but there has been no synthesis of the evidence surrounding this and, there are no clear oral health recommendations for people with cerebral palsy globally. This review synthesizes the existing knowledge base on oral health in people with cerebral palsy and provides recommendations for future research. METHODS A scoping review was conducted to assess the current literature. Databases were searched using relevant search terms. Study outcomes were synthesized according to their reported outcomes. RESULTS One hundred seventy three studies were included in this review. Children with cerebral palsy have an increased risk for dental caries and untreated caries. Higher saliva osmolality is a major contributor to increased dental caries. People with cerebral palsy are more likely to experience tooth wear and bruxism. Children and their care-givers have poor oral health related quality of life. There is a large unmet need for oral healthcare in this group. There is no suggested plan for the prevention of poor oral health for this group. A high number of studies included related to research is conducted in low- and middle-income countries, care should be taken in applying results outside this context. There is a lack of research conducted in people with cerebral palsy, 18 years and over. CONCLUSION There is a higher risk for poor oral health in people with cerebral palsy and there is a large unmet need to dental care in this group. This study highlights the need for further research to focus on adults with cerebral palsy and an of understanding the oral health care outcomes in the context of settings. The authors recommend the inclusion of classification systems and the integration of disability inclusive language in future studies.
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Affiliation(s)
- Karen Lansdown
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Michelle Irving
- School of Public Health, Faculty of Medicine and Health, Menzies Centre for Health Policy, University of Sydney, Camperdown, Australia
| | - Kimberly Mathieu Coulton
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
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3
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Martignon S, Roncalli AG, Alvarez E, Aránguiz V, Feldens CA, Buzalaf MAR. Risk factors for dental caries in Latin American and Caribbean countries. Braz Oral Res 2021; 35:e053. [PMID: 34076077 DOI: 10.1590/1807-3107bor-2021.vol35.0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Identifying the risk factors for dental caries is vital in epidemiology and clinical practices for developing effective preventive strategies, both, at the individual and collective levels. Different causality/determination models have been proposed to understand the development process of dental caries. In the present review, we designed a model inspired by the world-known social determinants models proposed in the 90s and more recently in the 10s, wherein the contextual factors are placed more externally and encompass the individual factors. The contextual factors included those related to the cultural and societal values, as well as the social and health government policies. The individual factors were classified into the following categories: socioeconomic (social class, occupation, income, and education level), demographic characteristics (age, sex, and ethnicity), behavioral factors (non-use of fluoride dentifrice, sugar consumption, poor oral hygiene, and lack of preventive dental care), and biological factors (recent caries experience/active caries lesions, biofilm retentive factors, developmental defects of the enamel, disabilities, saliva amount and quality, cariogenic biofilm). Each of these variables was addressed, while focusing on the current evidence from studies conducted in Latin American and Caribbean countries (LACC). Based on the proposed model, educational aspects were addressed, and individual caries risk assessment and management decisions were proposed; further, implications for public health policies and clinical practice were described. The identification of modifiable risk factors for dental caries should be the basis for multi-strategy actions that consider the diversity of Latin American communities.
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Affiliation(s)
- Stefania Martignon
- Universidad El Bosque, Caries Research Unit, Research Department, Bogotá, Colombia
| | | | - Evelyn Alvarez
- Universidad Científica del Sur, School of Dentistry, Department of Pediatric Dentistry, Lima, Perú
| | - Vicente Aránguiz
- Universidad de los Andes, Faculty of Dentistry, Cariology Unit, Santiago, Chile
| | - Carlos Alberto Feldens
- Universidade Luterana do Brasil, School of Dentistry, Department of Pediatric Dentistry, Canoas, RS, Brazil
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Sruthi KS, Yashoda R, Puranik MP. Oral health status and parental perception of child oral health-related quality of life among children with cerebral palsy in Bangalore city: A cross-sectional study. SPECIAL CARE IN DENTISTRY 2021; 41:340-348. [PMID: 33512001 DOI: 10.1111/scd.12568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/01/2021] [Accepted: 01/05/2021] [Indexed: 11/29/2022]
Abstract
AIM To assess and compare the oral health status and parental perception of child oral health-related quality of life (OHRQoL) among children with and without cerebral palsy (CP). METHODS AND RESULTS A cross-sectional comparative study was conducted among 300 children aged 5-15 years with and without CP in Bangalore city. Oral health status was assessed using WHO 2013 criteria, and malocclusion was assessed using Angle's classification of malocclusion. Parental perception of child OHRQoL was assessed using parental caregivers perceptions questionnaire. Chi-square test, Student's t-tests and logistic regression were applied. Majority of the study participants were males with a mean age of 10 years. Caries experience, gingivitis, dental trauma, and dental erosion were significantly higher among children with CP than the comparison group. Mean parental perception of child OHRQoL score among CP was significantly higher than that of comparison group (P < .001). Odds of having caries experience, gingivitis, dental trauma, and Angle's Class II/III malocclusion were significantly higher among CP children with poor OHRQoL compared to those without these conditions. CONCLUSION Oral health status among children with CP was poor than the children without CP. Parents perceived poor OHRQoL among children with CP when compared to those without CP. Hence CP has an impact on oral health necessitating preventive care.
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Affiliation(s)
- K S Sruthi
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
| | - R Yashoda
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
| | - Manjunath P Puranik
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
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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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Alvarenga ÉDSL, Silva AM, da Silva TAE, de Araújo RF, Prado Júnior RR, Mendes RF. Oral health-related quality of life in caregivers of individuals with Cerebral Palsy: a case-control study. Eur Arch Paediatr Dent 2019; 21:193-202. [PMID: 31471856 DOI: 10.1007/s40368-019-00472-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 08/20/2019] [Indexed: 02/07/2023]
Abstract
AIM The object of this study is to evaluate the oral health-related quality of life (OHRQoL) of caregivers of individuals with Cerebral Palsy (CP). METHODS Ninety-eight caregivers of individuals with CP (SG) and 196 caregivers of individuals without special needs (CG) completed the reduced version of the Oral Health Impact Profile (OHIP-14). In addition, a questionnaire with demographic and socioeconomic questions was used. Groups were matched according to gender, schooling and family income. Fisher's exact tests, Chi square and Mann-Whitney, and bi/multivariate logistic regression were used (p < 0.05). RESULTS The impact on OHRQoL was similar for SG and CG (OHIP-14 total score). For SG, the high negative impact was in the following OHIP domains: "Functional limitation", "Physical disability", "Psychological incapacity" and "Disadvantages". For SG, a higher number of caregivers was single, unemployed, received government financial aid. There was a statistically significant association between the number of children a caregiver has and a negative impact on OHRQoL. CONCLUSIONS Being a caregiver of children with or without CP had a negative impact of similar magnitude on ORHQoL. The negative impact on OHRQoL of caregivers of children with CP was associated with having a high number of children; the higher the number of children, the greater the negative impact on their OHRQoL.
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Affiliation(s)
- É da S L Alvarenga
- Postgraduate Program in Dentistry, Federal University of Piauí, UFPI, Campus Universitário Ministro Petrônio Portella, Bloco 5, Bairro Ininga, Teresina, PI, CEP: 64049-550, Brazil
| | - A M Silva
- Postgraduate Program in Dentistry, Federal University of Piauí, UFPI, Campus Universitário Ministro Petrônio Portella, Bloco 5, Bairro Ininga, Teresina, PI, CEP: 64049-550, Brazil.
| | - T A E da Silva
- Postgraduate Program in Dentistry, Federal University of Piauí, UFPI, Campus Universitário Ministro Petrônio Portella, Bloco 5, Bairro Ininga, Teresina, PI, CEP: 64049-550, Brazil
| | - R F de Araújo
- Postgraduate Program in Dentistry, Federal University of Piauí, UFPI, Campus Universitário Ministro Petrônio Portella, Bloco 5, Bairro Ininga, Teresina, PI, CEP: 64049-550, Brazil
| | - R R Prado Júnior
- Postgraduate Program in Dentistry, Federal University of Piauí, UFPI, Campus Universitário Ministro Petrônio Portella, Bloco 5, Bairro Ininga, Teresina, PI, CEP: 64049-550, Brazil
| | - R F Mendes
- Postgraduate Program in Dentistry, Federal University of Piauí, UFPI, Campus Universitário Ministro Petrônio Portella, Bloco 5, Bairro Ininga, Teresina, PI, CEP: 64049-550, Brazil
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Ferreira ACFM, Mayer MPA, Kawamoto D, Santos MTBR. Constipation, antiepileptic drugs, and gingivitis in children and adolescents with cerebral palsy. Int J Paediatr Dent 2019; 29:635-641. [PMID: 30817037 DOI: 10.1111/ipd.12488] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 01/24/2019] [Accepted: 02/22/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cerebral palsy (CP) individuals present with epilepsy, which requires the use of antiepileptic drug (AED). HYPOTHESIS Since an inflammatory response may contribute to epileptogenesis, the hypothesis tested was that constipation would be associated with gingivitis and the use of AED in children and adolescents (CA) with CP. DESIGN A comparative study was conducted with 101 CA aged 5-17 years (10.8 ± 4.9), classified as constipated (G1; n = 57) or not constipated (G2; n = 44). Clinical patterns, AED used, body mass index (BMI), fluid intake, toilet transfer, and gingival condition were evaluated. Student's t test, chi-squared test, and logistic regression analysis were performed (α = 0.05). RESULTS There were no differences between groups regarding gender (P = 0.531), age (P = 0.227), BMI (P = 0.437), and fluid intake (P = 0.346). G1, however, presented a higher percentage of quadriplegic individuals (P < 0.001), dependency for toilet transfer (P < 0.001), the presence of gingivitis (P = 0.020), and the use of AED polytherapy (P < 0.001) compared to G2. Constipation was associated with quadriplegic CA, using GABA as AED (P = 0.002). CONCLUSIONS Mucosal inflammation evidenced by constipation and gingivitis is associated with the most neurologically compromised CAs under the use of GABA AED.
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Affiliation(s)
| | - Marcia Pinto Alves Mayer
- Department of Microbiology, Oral Microbiology Laboratory, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Dione Kawamoto
- Department of Microbiology, Oral Microbiology Laboratory, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Akhter R, Hassan NMM, Martin EF, Muhit M, Smithers-Sheedy H, Badawi N, Khandaker G. Caries experience and oral health-related quality of life (OHRQoL) of children and adolescents with cerebral palsy in a low-resource setting. BMC Oral Health 2019; 19:15. [PMID: 30646890 PMCID: PMC6332610 DOI: 10.1186/s12903-018-0704-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 12/26/2018] [Indexed: 11/17/2022] Open
Abstract
Background Children with complex neurodevelopmental disabilities such as cerebral palsy (CP), have a higher risk of dental disease related at least in part to greater difficulties in performing and maintaining effective oral hygiene and oral care practices. However, to date, there are very few studies that have considered the impact of dental disease on the Oral Health-Related Quality of Life (OHRQoL) of children and adolescents with cerebral palsy. This study aimed to investigate the association between dental caries experience and oral health related quality of life (OHRQoL) among children and adolescents with cerebral palsy in a low-resource setting (Bangladesh). Methods A total of 90 children and adolescents with CP, 2–17 years old (median age 10 years; 37.8% female and 62.2% male) were randomly selected from the Bangladesh Cerebral Palsy Register (BCPR) The decayed, missing and filled teeth (dmft/DMFT) index was used to measure caries experience. Child Perceptions Questionnaire (CPQ) and Family Impact Scale (FIS) were used to assess oral health–related quality of life (OHRQoL). Binary logistic regression was used to investigate factors that may contribute to dental caries experience. Results Dental caries were observed among 55.6% of the participants. After adjusting for age and gender, binary logistic regression analysis showed that dental caries experience was significantly associated with those who had teeth/mouth pain (rate ratio 7.3; P = 0.02), food caught between teeth (rate ratio: 6.4; P = 0.02), difficulty in eating and drinking (rate ratio 5.9; p = 0.02) and those who felt frequently upset (rate ratio: 54.7; P = 0.02). Conclusion In this study, we found that children and adolescents with CP in a low-resource setting had high dental caries experience and that dental caries had a negative impact on OHRQoL amongst these participants and their parents/caregivers. Health care professionals should be aware of the importance of dental health and oral hygiene in this population. These findings highlight the need for oral health promotion programs for children and adolescents with CP in these settings to reduce pain and to improve quality of life.
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Affiliation(s)
- Rahena Akhter
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, C24 Westmead Hospital, Level 1 WCOH, Westmead, NSW, 2145, Australia.
| | | | - Elizabeth F Martin
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, C24 Westmead Hospital, Level 1 WCOH, Westmead, NSW, 2145, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Allambie Heights, NSW, Australia.,The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Allambie Heights, NSW, Australia.,The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia.,Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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Rollon-Ugalde V, Coello-Suanzes JA, Castaño-Seiquer A, Lledo-Villar E, Espinoza-Visval I, Lopez-Jimenez AM, Infante-Cossio P, Rollon-Mayordomo A. Validation of the Spanish version of the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire. Med Oral Patol Oral Cir Bucal 2018; 23:e588-e595. [PMID: 30148470 PMCID: PMC6167100 DOI: 10.4317/medoral.22553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/03/2018] [Indexed: 11/27/2022] Open
Abstract
Background The Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHC-OHRQOL-Q) is an instrument designed specifically for parents and caregivers of patients with special needs that has not yet been applied in Spain. The aim of this study was to adapt it to Spanish and evaluate its reliability and validity in patients with intellectual disability (ID) treated under general anesthesia. Material and Methods The study was conducted in two different stages: a) cross-cultural adaptation of the original questionnaire, and b) cross-sectional study on 100 parents and caregivers who completed the piloted FHC-OHRQOL-Q. The patients were examined according to the WHO methodology. Dental treatments performed were recorded. Statistical tests were used to evaluate reliability (internal consistency) and validity (content, criterion, construct and discriminant) of the instrument. Results The mean age was 24 years (range=4-71 years). The most frequent causes of ID were psychomotor retardation (25%) and cerebral palsy (24%). The items most frequently answered by parents and caregivers were eating and nutrition problems (80%) and bad breath/taste (57%). Reliability (Cronbach’s alpha coefficient) was considered excellent (alpha=0.80-0.95). The analysis of the factorial validity yielded similar results to the original questionnaire. The high response rate of items (>96%) allowed content validity. Criterion validity was confirmed by a significant correlation with questions on oral health and oral well-being. Discriminant validity was demonstrated by the significant association of ≥21.5 years of age with worse oral symptoms (p=0.034) and parental concerns (p=0.005), DMFT index ≥3 with daily life problems (p=0.02), ≥4 decayed teeth with daily life problems (p=0.001), and >2 dental extractions with oral symptoms (p=0.000), daily life problems (p=0.002) and parent´s perceptions (p=0.043). Conclusions The FHC-OHRQOL-Q in Spanish is a reliable and valid instrument to apply in clinical practice to evaluate the impact of OHRQOL in mostly adult patients with ID, accessible to Spanish-speaking parents and caregivers. Key words:Oral health-related quality of life, intellectual disability, cross-cultural validation, psychometric properties, validation, questionnaire.
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Affiliation(s)
- V Rollon-Ugalde
- School of Medicine, Avenida Dr. Fedriani s/n, 41009-Seville, Spain,
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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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Barros ALO, Barros AO, Barros GLDM, Santos MTBR. Sobrecarga dos cuidadores de crianças e adolescentes com Síndrome de Down. CIENCIA & SAUDE COLETIVA 2017; 22:3625-3634. [DOI: 10.1590/1413-812320172211.31102016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/02/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo foi avaliar o perfil e a sobrecarga de cuidadores de crianças/adolescentes com e sem síndrome de Down. As avaliações foram realizadas por meio dos questionários sobre o perfil e a sobrecarga dos cuidadores (Burden Interview), e o perfil das crianças/adolescentes. Estes questionários foram aplicados a 168 cuidadores. Os testes Qui-quadrado, Exato de Fisher e Análise de Variância foram empregados com nível de significância fixado em α = 5%. Ambos os grupos eram compostos por 84 participantes, e os cuidadores do grupo com deficiência apresentaram porcentagem significantemente maior para o sexo feminino (p = 0,001), faixa etária de 41-60 anos (p < 0,001), não possuíam ocupação laboral (p < 0,001), baixa renda per capita (p < 0,001), baixo nível de escolaridade (p = 0,021), religião católica (p = 0,001), maiores de problemas de saúde (p < 0,001), em uso de medicação continua (p < 0,001) e com nível de sobrecarga moderada (p < 0,001). As crianças/adolescentes com deficiência necessitavam significantemente maior auxilio para a alimentação (p = 0,051), banho (p = 0,006), vestuário (p = 0,042), controle de esfíncteres (p = 0,027) e higiene íntima (p < 0,001). Os cuidadores de crianças/adolescentes com síndrome de Down apresentam sobrecarga moderada, quando comparados à cuidadores de crianças/adolescentes normoreativas.
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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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Dambi JM, Jelsma J, Mlambo T. Caring for a child with Cerebral Palsy: The experience of Zimbabwean mothers. Afr J Disabil 2015; 4:168. [PMID: 28730030 PMCID: PMC5433478 DOI: 10.4102/ajod.v4i1.168] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 06/15/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The needs of caregivers of children with disability may not be recognized despite evidence to suggest that they experience increased strain because of their care-giving role. This strain may be exacerbated if they live in under-resourced areas. OBJECTIVES We set out to establish the well-being of caregivers of children with Cerebral Palsy (CP) living in high-density areas of Harare, Zimbabwe. In addition, we wished to identify factors that might be predictive of caregivers' well-being. Finally, we examined the psychometric properties of the Caregiver Strain Index (CSI) within the context of the study. METHOD Caregivers of 46 children with CP were assessed twice, at baseline, and after three months, for perceived burden of care and health-related quality of life (HRQoL) using CSI and EQ-5D respectively. The psychometric properties of the CSI were assessed post hoc. RESULTS The caregivers reported considerable caregiver burden with half of the caregivers reporting CSI scores in the 'clinical distress' range. Many of the caregivers experienced some form of pain, depression and expressed that they were overwhelmed by the care-giving role. No variable was found to be associated with clinical distress. The CSI demonstrated good overall internal consistency (Cronbach's Alpha = 0.8), stability over time (Z = 0.87, p = 0.381) and was significantly and negatively correlated with the EQ-5D VAS (Spearman's rho = -0.33, p = 0.027), demonstrating concurrent validity. CONCLUSION Caregivers must be monitored routinely for their level of distress and there is an urgent need to provide them with support. The CSI is likely to be a valid measure of distress in this population.
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Affiliation(s)
| | - Jennifer Jelsma
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Tecla Mlambo
- Department of Rehabilitation, University of Zimbabwe, Zimbabwe
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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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Abanto J, Shitsuka C, Murakami C, Ciamponi AL, Raggio DP, Bönecker M. Associated factors to erosive tooth wear and its impact on quality of life in children with cerebral palsy. SPECIAL CARE IN DENTISTRY 2014; 34:278-85. [DOI: 10.1111/scd.12070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jenny Abanto
- Post-PhD Student; University of São Paulo; Brazil
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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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Al-Gamal E. Quality of life and anticipatory grieving among parents living with a child with cerebral palsy. Int J Nurs Pract 2013; 19:288-94. [PMID: 23730861 DOI: 10.1111/ijn.12075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to describe the quality of life and anticipatory grieving among Jordanian parents living with a child with cerebral palsy. A cross-sectional, descriptive, correlational design was used with 204 Jordanian parents. Both mothers and fathers were recruited from health-care centres that provided comprehensive care for children with cerebral palsy in Jordan and from schools for special education. Structured interviews were conducted using the Marwit and Meuser Caregiver Grief Inventory Cerebral Palsy and Quality of Life Index. The majority of the parents reported that providing care for a child with cerebral palsy is requiring more emotional energy and determination than ever expected. There was a significant negative correlation between total anticipatory grief score and total quality of life score and all subscales. This indicates that parents with high level of intensity of anticipatory grief had lower quality of life. No statistically significant differences were found in anticipatory grief and quality of life responses between mothers and fathers. The outcomes of this study have important implications for encouraging family-centred care and inform policy to improve the lives of children with cerebral palsy and their parents.
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Affiliation(s)
- Ekhlas Al-Gamal
- Community Health Nursing Department, Faculty of Nursing, The University of Jordan, Amman, Jordan.
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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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Abanto J, Ortega AO, Raggio DP, Bönecker M, Mendes FM, Ciamponi AL. Impact of oral diseases and disorders on oral-health-related quality of life of children with cerebral palsy. SPECIAL CARE IN DENTISTRY 2013; 34:56-63. [DOI: 10.1111/scd.12028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jenny Abanto
- Postgraduate Student of Pediatric Dentistry and Orthodontics Department; Dental School; University of São Paulo-USP; Brazil
| | - Adriana Oliveira Ortega
- Posdoc sutdent at Stomatology Department; Dental School; University of Sao Paulo-USP; Brazil
| | - Daniela Prócida Raggio
- Professor of Pediatric Dentistry and Orthodontics Department; Dental School; University of São Paulo-USP; Brazil
| | - Marcelo Bönecker
- Chairman Professor of Pediatric Dentistry and Orthodontics Department; Dental School; University of São Paulo-USP; Brazil
| | - Fausto Medeiros Mendes
- Professor of Pediatric Dentistry and Orthodontics Department; Dental School; University of São Paulo-USP; Brazil
| | - Ana Lídia Ciamponi
- Professor of Pediatric Dentistry and Orthodontics Department; Dental School; University of São Paulo-USP; Brazil
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Moreira RN, Alcântara CEP, Mota-Veloso I, Marinho SA, Ramos-Jorge ML, Oliveira-Ferreira F. Does intellectual disability affect the development of dental caries in patients with cerebral palsy? RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1503-1507. [PMID: 22522208 DOI: 10.1016/j.ridd.2012.03.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 03/18/2012] [Accepted: 03/20/2012] [Indexed: 05/31/2023]
Abstract
The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of these, 76 individuals had been diagnosed with spastic cerebral palsy and 89 had no neurological impairment. The subjects were matched based on age and gender and selected randomly by lottery. All patients were examined to determine the number of dental cavities, and tested for their intellectual functioning (Raven Test) and motor abilities. The study showed that children with CP who presented with intellectual disabilities had a larger number of dental cavities than children with CP without intellectual disabilities. Considering intellectual functioning and motor impairment in the multivariate logistic regression, only intellectual functioning was found to have a significant effect on the development of dental cavities. These results suggest that intellectual disability can be considered a contributing factor for the development of dental caries in patients with cerebral palsy.
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Affiliation(s)
- Rafaela Nogueira Moreira
- School of Dentistry, Postgraduate Program in Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
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Abanto J, Carvalho TS, Bönecker M, Ortega AO, Ciamponi AL, Raggio DP. Parental reports of the oral health-related quality of life of children with cerebral palsy. BMC Oral Health 2012; 12:15. [PMID: 22708973 PMCID: PMC3500272 DOI: 10.1186/1472-6831-12-15] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 05/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The severity of physical and mental impairments and oral problems, as well as socioeconomic factors, may have an impact on quality of life of children with cerebral palsy (CP). The aim of this research was to assess the impact of impairments and oral health conditions, adjusted by socioeconomic factors, on the Oral Health-Related Quality of Life (OHRQoL) of children with CP using their parents as proxies. METHODS Sixty children, between 6-14 years of age were selected. Their parents answered a children's OHRQoL instrument (5 domains) which combines the Parental-Caregivers Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS). The severity of dental caries, type of CP, communication ability, gross motor function, seizures and socioeconomic conditions were assessed. RESULTS Considering the total score of the OHRQoL instrument, only the reduction of communication ability and dental caries severity had a negative impact on the OHRQoL (p < 0.05). Considering each domain of the instrument, the severity of the type of CP and its reduction of communication ability showed a negative impact on oral symptoms and functional limitations domains (p < 0.05). Seizures have a negative impact on oral symptoms domain (p = 0.006). The multivariate fitted model showed that the severity of dental caries, communication ability and low family income were negatively associated with the impact on OHRQoL (p = 0.001). CONCLUSIONS The severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.
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Affiliation(s)
- Jenny Abanto
- Pediatric Dentistry and Orthodontics Department, Dental School, University of São Paulo-USP, São Paulo, Brazil
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Santos MTBR, Ferreira MCD, Leite MF, Guaré RO. Salivary parameters in Brazilian individuals with cerebral palsy who drool. Child Care Health Dev 2011; 37:404-9. [PMID: 21083696 DOI: 10.1111/j.1365-2214.2010.01176.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although drooling of saliva is considered abnormal in a child over 4 years of age, it has been estimated to occur in approximately in 10-37% of children with cerebral palsy. AIM The aim of this study was to evaluate the flow rate, pH and buffering capacity in saliva of Brazilian individuals with cerebral palsy who drool. METHODS Cross-sectional assessment of saliva from 139 individuals with cerebral palsy (3-16 years old) enrolled in a specialized rehabilitation centre in Sao Paulo, Brazil, divided into two groups, according to the presence (G1) or absence (G2) of drooling and controls (G3): G1 consisted of 63 individuals who drool; G2 consisted of 76 who do not drool; and G3 consisted of 47 individuals with no neurological damage of similar age and sex. Unstimulated whole saliva was collected and salivary flow rate (mL/min), initial pH and buffering capacity, by titration of saliva with a constant amount of 0.01 N HCl, were evaluated. The results from G1, G2 and G3 were compared by one-way anova and the χ(2) -test. RESULTS A higher percentage of severe drooling (60.3%) was observed compared with moderate (27.0%) and mild (12.7%) in the cerebral palsy individuals who drool and the prevalence of drooling was highest among children and adolescents with spastic quadriplegia. Significant reductions in salivary flow rate, initial pH, buffering capacity of whole saliva in pH range 6.0-6.9 and total buffering capacity occurred in G1 and G2 compared with G3. CONCLUSION All individuals with cerebral palsy present lower flow rate, pH and buffering capacity of saliva, which increases the risk of oral diseases.
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Affiliation(s)
- M T B R Santos
- Discipline of Dentistry, Persons with Disabilities Division, Universidade Cruzeiro do Sul, São Paulo, Brazil.
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