Use of different oral hygiene strategies in children with cerebral palsy: A comparative study

Abstract

Background:Cerebral palsy (CP) is described as a group of conditions usually occurring in childhood, where children have motor dysfunction and are unable to adequately master the necessary techniques of plaque control, which ultimately leads to dental caries and periodontal problems.Aims:The objective of this study was to educate the parents/caretakers/institution staff and children with CP about the different preventive home care measures and to evaluate the oral hygiene and gingival health status of these children before and after the institution of different preventive home care measures.Materials and Methods:A total of 64 individuals with CP, aged between 6 and 18 years, were examined for their oral hygiene and gingival health status, after which the parents/caretakers received a health education program. The children were then randomly divided into four groups. Each group was administered a specific preventive home care measure (mechanical and chemotherapeutic) to be followed for a period of 6 weeks, and the oral hygiene and the gingival health status were recorded at the end of 1 week, 2 weeks, and 6 weeks. The data were then subjected to statistical analysis.Results:In the sample of 64 children diagnosed with CP, the mean OHI(S) score among the groups of children who were given different preventive home care measures was compared at baseline, 1 week, 2 weeks, and 6 weeks. Group 4 showed a marked reduction in the OHI(S) score measured from baseline to 6 weeks, when compared to the other three groups which wa statistically very highly significant (P < 0.001) The mean MGI score was compared at baseline, 1 week, 2 weeks, and 6 weeks home, Group 4 showed a marked reduction in the MGI score measured from baseline to 6 weeks, when compared to the other three groups. When the mean MGI score was compared from baseline to 6 weeks, there was a gradual decrease in the MGI score, which was statistically highly significant between baseline and 1 week (P < 0.05) and statistically very highly significant between 1 and 2 weeks (P < 0.001). However, this improvement was not statistically significant between 2 and 6 weeks (P > 0.05).Conclusion:A combined mechanical and chemotherapeutic measure is highly recommended to maintain the oral hygiene and gingival health of these special children because of their difficulties and their limited abilities to control dental plaque.

Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review

“…This review included one RCT and three pre-post intervention studies. Of the pre-post studies, one was conducted in two special schools in the Bangalore city, India, and children were randomly divided into four groups, although the sample size per group was small (16 children per group) [ 66 ]. Another pre-post study was conducted in the developmental clinic with pediatrician completing detailed history and neurological examination to confirm CP.…”

“…Parent components: In a randomized open-blinded study by Maiya et al (2015), parents were taught different preventive home care measures through educational programmes [ 66 ]. Two other studies, Karande et al (2008) and Arora et al (2014), targeted parental knowledge about CP, its probable a etiology, and available treatment and rehabilitation options [ 92 , 93 ].…”

“…Service providers: Interventions were provided by a trainer (1), a pediatrician (1), or a therapist (1) through film, educational programmes, or mother-child groups. Ways of delivering: The interventions were provided by closed group sessions, one-to-one session and practical sessions through educational film, flash card, pictorial manuals, or health advice to the parents [ 48 , 66 ]. Time to evaluation or end-line: The time from intervention to evaluation varied from one week to 12 months.…”

“…Three studies increased parent knowledge [ 34 , 92 ]. One study reported improvements in knowledge regarding maintaining oral hygiene [ 66 ] ( Table 4 ). Out of four studies on CP, three recorded parental knowledge and used locally developed questionnaires specific to the studies.…”

“…In high-income countries, parent-mediated programmes are generally embedded in regular intervention programs administered through special educational centres [ 57 , 59 , 65 ], while most children with NDDs in low-income countries do not have access to professional or educational support due to an inadequate number of specialized clinics and schools and a shortage of qualified special educators [ 66 , 67 ]. Training programs to improve parents’ skills could create an alternative workforce in a setting where institutional support for children with NDD is limited, and this could be a sustainable strategy to address the needs of a large number of children with NDDs, particularly in the low-resource settings in South Asia [ 31 , 64 , 68 ].…”