Salivary Biomarker Levels and Oral Health Status of Children with Cerebral Palsy and Their Healthy Siblings: A Comparative Study

Abstract

Background: The dental needs of cerebral palsy children are an area of study much in need of attention. The neglect of this aspect should be rectified, and simpler diagnostic methodologies should be established and used to serve this purpose. Aim: This study aimed to determine oral health status and salivary biomarkers (salivary flow rate, pH, buffering capacity) among children with cerebral palsy (CP), to compare their data with that of their healthy siblings, and to evaluate the relationship between salivary biomarkers and dental caries. Methods: A total of 30 CP children (study group) and 30 normal healthy siblings (controls) were selected between the ages of 5 and 12 years. Salivary biomarkers were assessed, and oral health status was examined. Statistical Analysis: Chi-square test was used for comparison of oral health status. “Unpaired t test was used to compare caries indexes (decay/filled teeth–primary dentition [dft] and decay/missing/filled teeth–permanent dentition [DMFT]) and salivary biomarkers between the groups. Pearson correlation was used to find the correlation between salivary biomarkers and caries. Results: The dft scores were significantly higher in the study group (P<0.05). The pH values and salivary flow rates were significantly lower in the study group (P<0.05 and P<0.001, respectively). There was a significant correlation between DMFT scores and salivary flow rate in the study group (P<0.05). Conclusion: Low pH and low salivary flow rate might be risk factors for dental caries in CP populations; moreover, the significant correlation between DMFT score and salivary flow rate suggests that salivary flow rate could be used as a screening tool for assessing at-risk subjects in such populations.

From Mouth to Brain: Distinct Supragingival Plaque Microbiota Composition in Cerebral Palsy Children With Caries

“…Additionally, the daily diet of CP patients mainly consists of semisolid or liquid foods and often contain a high proportion of sugar; collectively, these can lead to the increased adhesion of diets and plaque formation ( Selwitz et al., 2007 ; De Camargo and Antunes, 2008 ; Arvedson, 2013 ; Akhter et al., 2017 ). Furthermore, CP patients show low pH, low buffering capacity, low salivary flow rate, and high osmotic pressure in saliva ( Anjugam et al., 2021 ). These risk factors establish a particular oral environment for CP patients, providing an evolutionary drive for microorganisms to adapt to this variation.…”

A scoping review of oral health outcomes for people with cerebral palsy

“…The majority of studies included participants with cerebral palsy living in low‐ and middle income countries (69/107, 64.5%). Whilst the results of studies varied, research from low‐ and middle income countries generally reported that children with cerebral palsy experience increased risk for dental caries and untreated dental caries 12–15 . However, other findings in low‐ and middle income countries report lower or no difference in caries experience in children with cerebral palsy versus control groups 16–18 …”

“…Multiple studies demonstrate lower flow rates, pH and buffering capacity of saliva and higher osmolality rates among all age groups 13,50–52 . The majority of studies on saliva had a pediatric focus and were conducted in low‐ and middle income countries.…”

“…Whilst the results of studies varied, research from low-and middle income countries generally reported that children with cerebral palsy experience increased risk for dental caries and untreated dental caries. [12][13][14][15] However, other findings in low-and middle income countries report lower or no difference in caries experience in children with cerebral palsy versus control groups. [16][17][18] Approximately 35% of studies included adults with cerebral palsy.…”

“…Multiple studies demonstrate lower flow rates, pH and buffering capacity of saliva and higher osmolality rates among all age groups. 13,[50][51][52] The majority of studies on saliva had a pediatric focus and were conducted in lowand middle income countries. It was indicated that salivary osmolality exhibits a stronger association for dental caries than salivary flow rate.…”