Oral Health and the Child With Cerebral Palsy

Oral Health Behaviors of Preschool Children With Cerebral Palsy: A Case-Control Community-Based Study

Du RY, McGrath CP, Yiu CK, King NM
Spec Care Dentist. 2014;34:298-302

Study Summary

Oral healthcare providers are entrusted with providing oral care to all members of the population, and advanced training may be required to administer care to specific groups, including those with special needs. Cerebral palsy (CP) represents a group of neurologic disorders attributed to nonprogressive disturbances in the fetal or infant brain, resulting in severe physical disability.^[1] In addition to having posture and movement disorders, individuals with CP frequently experience disturbances of sensation, perception, cognition, and communication.^[1]

Individuals with CP are reported to have a wide range of orofacial health problems owing to structural changes and neuromuscular deficits in these anatomical regions.^[2] These may include dental and facial trauma, developmental enamel defects, erosive tooth wear, dental caries, and periodontal diseases.^[1,2,3]

Oral health behaviors, such as oral hygiene practices and utilization of dental services, influence development of common oral diseases, and identification of these behaviors is important for disease prevention. Du and colleagues described and compared oral health behavioral practices of preschool children with and without CP to assess the oral health knowledge and oral health attitudes of their primary caregivers (PCGs). Preschool children with CP were identified from a complete list of special childcare centers in the Hong Kong Special Administrative Region (HKSAR), China. Ninety-four children with CP were identified and their PCGs were invited to participate in the study, but only 72 consented to participate. An age- and gender-matched control group of children from mainstream preschools in the geographical areas was recruited.

Structured questionnaires were used for data collection to assess oral health behaviors, oral health knowledge, and oral health attitudes. To assess oral health behaviors, the focus of the assessment was on dental attendance, oral hygiene practices, and snacking habits. To assess PCG's oral health knowledge, questions focused on such areas as causes of dental caries, ways to prevent dental caries, causes of periodontal diseases, and ways to prevent periodontal diseases. Possible scores ranged from 0 to 3 for each of the four questions, with a maximum score of 12. Oral health attitudes of the PCGs were assessed using an eight-item scale, with statements reflecting general concepts about dental health and appearance related to missing and/or false teeth. This score ranged from 0 to 8, with a higher score representing a more positive attitude.

The major findings of the study were:

The mean age of the children was 56 months (range, 30-77 months) and 54% were boys.
Only 23.6% of children with CP ever attended a dentist compared with 40% in the control group. Dental attendance for children both in the case and control groups was predominantly problem- or treatment related.
There were no significant differences in frequency of tooth brushing per day, use of toothpaste, or frequency of snacking between the case and control groups.
PCGs of children with CP more frequently reported assisting their children with tooth brushing when compared with PCGs of children in the control group.
There were no significant differences in the oral health knowledge and oral health attitudes of PCGs between the case and control groups (9.47 vs 9.56 and 6.41 vs 6.49, respectively).

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