Oral hydration in children with cerebral palsy

Abstract

Salivary osmolality reflects the hydration status of individuals with cerebral palsy necessary for adequate unstimulated salivary flow rate. Aim: To investigate whether oral motor performance is determinant for the hydration status and the effect of a supplemental oral fluid supply on salivary osmolality. Methods: The sample consisted of 99 children with cerebral palsy aged 6 to 13 years old. In this study, children participated in 2-day evaluations: 1 st day -baseline: saliva collection, caries experience and oral motor performance evaluations; and 2 nd day: saliva collection after supplemental fluid supply. Prior to each evaluation, the participants were trained for saliva collection. Unstimulated whole saliva was collected using cotton roll at baseline, with the amount of fluid usually offered by caregivers, and 48 h after baseline, with as much as twice the normal daily fluid intake previously offered. Salivary osmolality was measured using a freezing point depression osmometer. Caries experience index for decayed, missed and filled teeth (DMFT) was evaluated. According to the Oral Motor Assessment Scale, the children were classified into subfunctional or functional groups. Chi-square, Student's t test and Pearson's correlation coefficient were used. Results: The subfunctional group presented a higher percentage of quadriplegic children (p<0.001), with significantly higher values for caries experience (p<0.001) and salivary osmolality (p<0.001), which did not diminish when supplemental fluid supply was offered, compared with the functional group (p=0.001). Conclusions: The effectiveness of oral motor performance plays an important role in the hydration status of children with cerebral palsy and those with worse oral motor performance may be at higher risk of oral diseases.

Caracterização dos pacientes e procedimentos executados no serviço de atendimento a pacientes com necessidades especiais da Faculdade de Odontologia de Araraquara – UNESP

“…Entre os indivíduos atendidos nas clínicas da FOAr, 20,7% apresentavam paralisia cerebral, condição caracterizada por uma lesão cerebral não progressiva, com alterações neuromusculares e esqueléticas 11 . A elevada prevalência da cárie dental em pacientes com paralisia cerebral 12 e, consequentemente, a alta necessidade de tratamento odontológico curativo, pode estar ligada a diferentes fatores, como a severidade da paralisia cerebral e o nível do retardo mental.…”

"Estudo da prevalência de cárie em pacientes portadores de paralisia cerebral"

“…A maior parte dos pacientes examinados era do sexo masculino; outros estudos sobre prevalência de cárie em pacientes com necessidades especiais também tiveram em sua amostra maior número de participantes do sexo masculino (DONNELL;SHEIHAM;WAI, 2002;MAURER et al, 1996;MITSEA et al, 2001;POPE;CURZON, 1991;PRAT;JIMÉNEZ;QUESADA, 2003;SANTOS et al, 2003;SHYAMA et al, 2001;HOLST,1987;VAZQUEZ et al, 2002) (FEUER, 1970;FOURNIOL, 1998;GUARÉ;CIAMPONI, 2003;KANEKO, 1976;KAVANAGH, 1982;LEFÈVRE;DIAMENT, 1990;BECKER;RAMOS, 1997;MAGNUSSON;VAL, 1963;MOLLER, 1976;MORREY, 1951;NIELSEN, 1990;PIOVESANA, 1998;POPE;CURZON, 1991;SANTOS et al, 2003;HALLONSTEN;NIELSEN, 1992;WEDDELL et al, 1991).…”

“…O desconhecimento sobre a PC pode deixar o profissional pouco à vontade para atender estes pacientes ou até levá -lo à recusa em atendê-los. A busca de conhecimento sobre a PC seria uma necessidade do cirurgião dentista, que permitiria melhorar seu conhecimento e disposição a tratá-los (ADELSON, 1957;HENGEN, 1980;WEDDEL et al, 1991 Kaneko (1976), Magnusson e Val (1963), Nielsen (1990), Piovesana (1998), Santos et al (2003, Sznajder et al (1965). Podemos aqui ressaltar que nenhum paciente portador de PC é igual ao outro; não seriam afetados da mesma forma (HENGEN, 1980;ROSENBAUM, 2003;WEDDELL et al, 1991).…”

“…Estudos comparativos de prevalência de cárie entre indivíduos portadores de PC (grupo de estudo) e não portadores (grupo controle) demonstraram índice CPO-D mais elevado no grupo de estudo (ALBUM et al, 1964;KANEKO, 1976;MAGNUSSON;VAL, 1963;MORALES, 1987;PRAT;JIMÉNEZ;QUESADA, 2003;SANTOS et al, 2003;SHMARAK;BERNSTEIN, 1961;SHYAMA et al, 2001;SZNAJDER et al, 1965). A prevalência de cárie mostrou-se inferior nos portadores de PC no estudo de Nielsen (1990).…”

A comparative study on oral health status in Greek preschool children with neurodevelopmental disorders with movement limitations

“…5 Limited motor performance of mastication and swallowing together with cariogenic diet, which is a frequent finding in these children, result in increased risk for dental caries. 6,7 Furthermore poor oral hygiene together with motor problems, result in poor gingival status and calculus deposits 6 while the use of antiseizure medications (phenytoin), can cause fibrous gingival enlargement. These children may often display low unstimulated salivary flow rates, pH and buffer capacity, and increased salivary osmolality and total protein concentration.…”