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Sarvas E, Webb J, Landrigan-Ossar M, Yin L. Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report. Pediatrics 2024; 154:e2024067603. [PMID: 39034828 DOI: 10.1542/peds.2024-067603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 07/23/2024] Open
Abstract
Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures.
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Affiliation(s)
| | | | | | - Larry Yin
- Associate Professor of Clinical Pediatrics, Keck School of Medicine of USC and Children's Hospital Los Angeles, Los Angeles, California
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Meng M, Xie Y, Cao J, Yu Y, Zhou X, Zou J. Effects of bonded spurs, fixed and removable palatal crib in the early treatment of anterior open bite: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 163:298-310. [PMID: 36564317 DOI: 10.1016/j.ajodo.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by different authors. This meta-analysis aimed to evaluate the effect of bonded spurs, fixed and removable palatal cribs in the early treatment of AOB. METHODS A comprehensive electronic search was carried out through PubMed, Embase (via Ovid), MEDLINE (via Ovid), Cochrane Central Register of Controlled Trials, and Web of Science up to May 1, 2022. This meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The work was carried out by 2 reviewers in duplicate and independently, including electronic searching, data extracting, risk of bias assessment, quality of evidence grading, heterogeneity and statistical power analysis, and eligibility evaluation of the retrieved articles. RESULTS Four studies out of 181 articles were recruited in the meta-analysis after applying the inclusion and exclusion criteria. The results showed that bonded lingual spurs and fixed palatal crib or spurs produced similar overbite changes (mean difference, -0.32; 95% confidence interval, -1.06 to 0.43; P = 0.41; I2 = 27%; meta power = 0.099). Fixed palatal crib and removable palatal crib also exhibited comparable effects in correcting AOB (mean difference, -0.02; 95% confidence interval, -0.90 to 0.86; P = 0.96; I2 = 0%; meta power = 0.2182). The quality of evidence about these 2 outcomes assessed with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was low. CONCLUSIONS Bonded lingual spurs, fixed palatal crib or spurs, and removable palatal crib had similar effects in the early treatment of AOB. Because the number of included studies was limited and only the overbite changes before and after treatment were assessed, more clinical randomized controlled studies with longer follow-ups are needed to get more clinically significant advice.
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Affiliation(s)
- Mingmei Meng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yongting Xie
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingwei Cao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Yu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Jing Zou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Havner C, Roussakis AÖ, Sjögreen L, Westerlund A. Open Bite Malocclusion and Orofacial Dysfunction in Patients with Myotonic Dystrophy Type 1 and Duchenne Muscular Dystrophy. J Neuromuscul Dis 2023; 10:885-896. [PMID: 37334614 PMCID: PMC10578289 DOI: 10.3233/jnd-230025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/20/2023]
Abstract
Open bite (OB) is a common malocclusion in individuals with orofacial dysfunction and syndromes, especially in neuromuscular diseases. OBJECTIVES The objectives were to explore the prevalence of OB in myotonic dystrophy type 1 (DM1) and Duchenne muscular dystrophy (DMD) and to create and compare orofacial dysfunction profiles. METHODS In this database study, 143 individuals with DM1 and 99 with DMD were included. The Mun-H-Center questionnaire and observation chart were used together with the Nordic Orofacial Test -Screening (NOT-S) to create orofacial dysfunction profiles. OB was categorised as: lateral (LOB); anterior (AOB); severe anterior (AOBS); or both types of anterior OB (AOBTot). Descriptive and multivariate statistics were used to compare the OB prevalence and to study associations with orofacial variables, respectively. RESULTS There was a statistically significant difference in OB prevalence between the DM1 (37%) and DMD (49%) groups (p = 0.048). LOB was seen in < 1% of DM1 and 18% of DMD. LOB was associated with macroglossia and closed mouth posture, AOB with hypotonic lips, and open mouth posture and AOBS with hypotonic jaw muscles. The orofacial dysfunction profiles showed similar patterns, although the mean NOT-S total scores for DM1 and DMD were 4.2±2.8 (median 4.0, min-max 1-8) and 2.3±2.0 (median 2.0, min-max 0-8), respectively. LIMITATIONS The two groups were not age- or gender-matched. CONCLUSION OB malocclusion is common in patients with DM1 and DMD and is associated with different types of orofacial dysfunction. This study highlights the need for multi-disciplinary assessments to support tailored treatment strategies that improve or sustain orofacial functions.
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Affiliation(s)
- Christina Havner
- Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mun-H-Center, Orofacial Resource Centre for Rare Diseases, Public Dental Service, Gothenburg, Sweden
| | - Anna Ödman Roussakis
- Mun-H-Center, Orofacial Resource Centre for Rare Diseases, Public Dental Service, Gothenburg, Sweden
| | - Lotta Sjögreen
- Mun-H-Center, Orofacial Resource Centre for Rare Diseases, Public Dental Service, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Lin L, Zhao T, Qin D, Hua F, He H. The impact of mouth breathing on dentofacial development: A concise review. Front Public Health 2022; 10:929165. [PMID: 36159237 PMCID: PMC9498581 DOI: 10.3389/fpubh.2022.929165] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/24/2022] [Indexed: 01/24/2023] Open
Abstract
Mouth breathing is one of the most common deleterious oral habits in children. It often results from upper airway obstruction, making the air enter completely or partially through oral cavity. In addition to nasal obstruction caused by various kinds of nasal diseases, the pathological hypertrophy of adenoids and/or tonsils is often the main etiologic factor of mouth breathing in children. Uncorrected mouth breathing can result in abnormal dental and maxillofacial development and affect the health of dentofacial system. Mouth breathers may present various types of growth patterns and malocclusion, depending on the exact etiology of mouth breathing. Furthermore, breathing through the oral cavity can negatively affect oral health, increasing the risk of caries and periodontal diseases. This review aims to provide a summary of recent publications with regard to the impact of mouth breathing on dentofacial development, describe their consistencies and differences, and briefly discuss potential reasons behind inconsistent findings.
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Affiliation(s)
- Lizhuo Lin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhao
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom,*Correspondence: Fang Hua
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Hong He
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Malocclusion in children with speech sound disorders and motor speech involvement: a cross-sectional clinical study in Swedish children. Eur Arch Paediatr Dent 2022; 23:619-628. [PMID: 35776286 PMCID: PMC9338153 DOI: 10.1007/s40368-022-00728-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 06/10/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate the occurrence, types and severity of malocclusions in children with speech sound disorder (SSD) persisting after 6 years of age, and to compare these findings to a control group of children with typical speech development (TSD). METHODS In total, 105 children were included: 61 with SSD and motor speech involvement (mean age 8:5 ± 2:8 years; range 6:0-16:7 years, 14 girls and 47 boys) and 44 children with TSD (mean age 8:8 ± 1:6; range 6:0-12:2 years, 19 girls and 25 boys). Extra-oral and intra-oral examinations were performed by an orthodontist. The severity of malocclusion was scored using the IOTN-DHC Index. RESULTS There were differences between the SSD and TSD groups with regard to the prevalence, type, and severity of malocclusions; 61% of the children in the SSD group had a malocclusion, as compared to 29% in the TSD group. In addition, the malocclusions in the SSD group were rated as more severe. Functional posterior crossbite and habitual lateral and/or anterior shift appeared more frequently in the SSD group. Class III malocclusion, anterior open bite and scissors bite were found only in the SSD group. CONCLUSION Children with SSD and motor speech involvement are more likely to have a higher prevalence of and more severe malocclusions than children with TSD.
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Mogren Å, Sand A, Havner C, Sjögreen L, Westerlund A, Agholme MB, Mcallister A. Children and adolescents with speech sound disorders are more likely to have orofacial dysfunction and malocclusion. Clin Exp Dent Res 2022; 8:1130-1141. [PMID: 35723352 PMCID: PMC9562821 DOI: 10.1002/cre2.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/08/2022] Open
Abstract
Background Children with speech sound disorders (SSD) form a heterogeneous group that differs in terms of underlying cause and severity of speech difficulties. Orofacial dysfunction and malocclusions have been reported in children with SSD. However, the association is not fully explored. Objectives Our aims were to describe differences in orofacial function and malocclusion between a group of children and adolescents with compared to without SSD and to explore associations between those parameters among the group with SSD. Methods A total of 105 participants were included, 61 children with SSD (6.0–16.7 years, mean age 8.5 ± 2.8, 14 girls and 47 boys) and 44 children with typical speech development (TSD) (6.0–12.2 years, mean age 8.8 ± 1.6, 19 girls and 25 boys). Assessments of orofacial function included an orofacial screening test and assessment of bite force, jaw stability, chewing efficiency, and intraoral sensory‐motor function. Possible malocclusions were also assessed. Result Children with SSD had both poorer orofacial function and a greater prevalence of malocclusion than children with TSD. Furthermore, children with SSD and poorer orofacial function had a greater risk of malocclusion. Conclusion Our result suggests that children with SSD are more prone to having poorer orofacial function and malocclusion than children with TSD. This illustrates the importance of assessing coexisting orofacial characteristics in children with SSD, especially since orofacial dysfunction may be linked to an increased risk of malocclusion. This result highlights the need for a multiprofessional approach.
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Affiliation(s)
- Åsa Mogren
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
| | - Christina Havner
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Lotta Sjögreen
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Monica Barr Agholme
- Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry Karolinska Institutet Stockholm Sweden
| | - Anita Mcallister
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
- Medical Unit Speech and Language Pathology, Women's Health and Allied Health Professionals Theme Karolinska University Hospital Stockholm Sweden
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de Castelo Branco Araújo T, Nogueira BR, Mendes RF, Júnior RRP. Oral health-related quality of life in children and adolescents with cerebral palsy: paired cross-sectional study. Eur Arch Paediatr Dent 2022; 23:391-398. [PMID: 35124753 DOI: 10.1007/s40368-022-00694-x] [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: 02/21/2021] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the impact of oral health conditions on the Oral Health-Related Quality of Life (OHRQoL) in children and adolescents with Cerebral Palsy (CP) and compare with children and adolescents without CP. METHODS This was a paired cross-sectional study, consisting of 121 children and adolescents with CP and 121 without CP, aged 6 to 14 years. Caregivers filled a socioeconomic-demographic and the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Physical examination of the oral cavity assessed the dental caries experience, need for treatment, consequences of untreated dental caries, presence of dental trauma, bruxism and malocclusion. A descriptive analysis and Kruskal-Wallis and Mann-Whitney tests (p < 0.05) were performed. Variables with p values ≤ 0.20 in the bivariate analysis were included in the adjusted model analysis. Variables with a p value < 0.05 remained in the final Poisson Regression model. RESULTS Caries experience had a negative impact on the quality of life of both groups, with and without CP. Presence of gastroesophageal reflux and difficulty to opening the mouth also had a negative impact on the OHRQoL of the group with CP. CONCLUSION Children and adolescents with CP suffered a greater negative impact on OHRQoL than individuals without CP. Difficulty in opening the mouth and the presence of GER had a negative effect on the quality of life of individuals with CP, while dental caries had a negative impact on the OHRQoL of children and adolescents of both groups.
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Affiliation(s)
- T de Castelo Branco Araújo
- Postgraduate Program in Dentistry, Federal University of Piauí-UFPI, Minister Petrônio Portella Campus, Bloc 5, Teresina, PI, 64049-550, Brazil.
| | - B R Nogueira
- Department of Restorative Dentistry, Federal University of Piauí-UFPI, Teresina, PI, Brazil
| | - R F Mendes
- Postgraduate Program in Dentistry, Federal University of Piauí-UFPI, Minister Petrônio Portella Campus, Bloc 5, Teresina, PI, 64049-550, Brazil.,Department of Restorative Dentistry, Federal University of Piauí-UFPI, Teresina, PI, Brazil
| | - R R P Júnior
- Postgraduate Program in Dentistry, Federal University of Piauí-UFPI, Minister Petrônio Portella Campus, Bloc 5, Teresina, PI, 64049-550, Brazil.,Department of Restorative Dentistry, Federal University of Piauí-UFPI, Teresina, PI, Brazil
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Alsayed Tolibah Y, Kouchaji C, Lazkani T, Abbara MT, Jbara S, Baghdadi ZD. Dental Care for a Child with Congenital Hydrocephalus: A Case Report with 12-Month Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1209. [PMID: 33572890 PMCID: PMC7908211 DOI: 10.3390/ijerph18031209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/16/2022]
Abstract
Hydrocephalus affects the central nervous system as a result of progressive ventricular dilatation from the accumulation of cerebrospinal fluid in the brain's lateral ventricles. This paper reports on the oral characteristics of a child with congenital hydrocephalus, discusses her complex dental care needs, and presents dental management of this case. Despite the complex and challenging dental needs, this child received dental treatment in a chairside approach without general anesthesia. A thorough knowledge of the patient's medical condition, together with expert clinical skills, was indispensable for managing the child and improving the quality and length of her life.
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Affiliation(s)
- Yasser Alsayed Tolibah
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (Y.A.T.); (C.K.)
| | - Chaza Kouchaji
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (Y.A.T.); (C.K.)
| | - Thuraya Lazkani
- Department of Restorative Dentistry and Endodontics, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (T.L.); (M.T.A.)
| | - Mohammad Tamer Abbara
- Department of Restorative Dentistry and Endodontics, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (T.L.); (M.T.A.)
| | - Saffana Jbara
- Department of Preventive Dental Science Division of Pediatric Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada;
| | - Ziad D. Baghdadi
- Department of Preventive Dental Science Division of Pediatric Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada;
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