BackgroundThe 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.MethodsSixty 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.ResultsConsidering 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).ConclusionsThe severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.
Cerebral palsy (CP) is one of the most frequent conditions encountered in the daily practice of dentists who treat special-needs patients and it seems that parafunctional oral habits are often present in such individuals. The aim of this study was to investigate the frequency of occurrence of parafunctional habits in individuals with CP. Sixty-five patients with CP were evaluated through a questionnaire and clinical observation, regarding the following habits: pacifier-sucking, finger-sucking, biting objects, tongue interposition, and bruxism. The results showed that nine (13.8%) patients presented with pacifier-sucking, four (6.1%) showed finger-sucking, 12 (18.4%) had the habit of biting objects, 27 (41.5%) presented with tongue interposition, and 24 (36.9%) had eccentric bruxism. The significance of the presence of oral parafunctional habits in individuals with CP, revealed in this study, justifies the need to establish protocols for adequate prevention and clinical intervention in order to minimize the deleterious consequences that may result from such habits.
The aim of this study was to investigate the impact of oral diseases and disorders on the oral-health-related quality of life (OHRQoL) of children with CP, adjusting this impact by socioeconomic factors. Data were collected from 60 pairs of parents-children with CP. Parents answered the child oral health quality of life questionnaire (parental-caregivers perception questionnaire and family impact scale) and a socioeconomic questionnaire. Dental caries experience, traumatic dental injuries, malocclusions, bruxism, and dental fluorosis were also evaluated. The multivariate adjusted model showed that dental caries experience (p < 0.001) and the presence of bruxism had a negative impact (p = 0.046) on the OHRQoL. A greater family income had a positive impact on it (p < 0.001). Dental caries experience and bruxism are conditions strongly associated with a negative impact on OHRQoL of children with CP and their parents, but a higher family income can improve this negative impact.
The purpose of this study was to evaluate the in vivo effectiveness of laser fluorescence compared to visual inspection and radiography for the detection of occlusal caries in primary teeth. Fifty sites from 30 molars in 29 patients were selected and evaluated under standardized conditions by 2 previously trained examiners according to the 3 diagnostic methods. Histological examination served as gold standard after exfoliation or extraction. Values obtained for sensitivity, specificity and accuracy were 0.60, 0.90 and 0.73 for laser fluorescence, 0.82, 0.85 and 0.84 for visual inspection and 0.62, 0.73 and 0.67 for radiography, respectively. Considering only dentinal caries, values were 0.73, 0.95 and 0.90 for laser fluorescence, 0.61, 1.00 and 0.90 for visual inspection and 0.96, 0.81 and 0.85 for radiography, respectively. We conclude that for the detection of occlusal caries in primary molars laser fluorescence presents a similar accuracy when compared to visual inspection and radiography, although visual inspection showed better values for sensitivities for both enamel and dentin lesions.
When planning the dental treatment of patients with Down syndrome (DS), dental practitioners should always consider their general health, in order to achieve a holistic and interdisciplinary approach. This article presents a literature review of the primary medical conditions in patients with DS that may affect their general health care and the appropriate clinical delivery of oral health care.
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