Bizarra MF, Luís HS, Bernardo MFaculdade de Medicina Dentária da Universidade de Lisboa

Oral health is often described as weak in people with cerebral

palsy (CP) due to difficulties in maintaining satisfactory oral

hygiene. In addition, lack of neuromuscular control, persistent

reflexes and oral mucosa sensibility and systemic health

problems.1

Aim: To evaluate the influence of institutionalization type and

number of years, brushing dependency and frequency, on

cerebral palsy individual’s dental hygiene.

An observational study was developed after approval by the

Ethics Committee of the Faculty of Dental Medicine at the

University Lisbon, institutional and parents/tutors authorization.

Data collection was made by analysis of clinical records,

regarding the type of the CP, brushing dependency and

frequency, institutionalization years and type (daily regime

and/or homecare). To evaluate the efficacy of tooth brushing the

Simplifed Oral Hygiene Index (OHI-S) was used. Inclusion

criteria were been teenagers or adults that attend or live in

institutions with more than 3 individuals with CP.

The data was analysed using IBM SPSS Statistics 25 applying

the Kruskal Wallis and the method Forward Stepwise for linear

regression tests.

30 institutions 415 individuals with CP

1-Al-Allaq T, DeBord TK, Liu H, Wang Y, Messadi DV. Oral health status ofindividuals with cerebral palsy at a nationally recognized rehabilition center.Spec Care Dentist. 2015;35(1):15-21. 2- Chu, C. H. & Lo, E. C. (2010). Oralhealth status of Chinese teenagers with cerebral palsy. Community Dent Health;27 (4): 222-6. 3-Kaur, S., Malhotra, R., Malhotra, R., Kaur, H., Batru, V. S. &Kaur, A. (2014). Oral hygiene status of mentally and physically challengedindividuals living in a specialized institution in Mohali, India. Ind J OralScienc., 4 (1) 17-22. 4-Jain, M., Mathur, A., Sawla, L., Choudhary, G., Kabra,K., Duraiswamy, P. & Kulkarni, S. (2009). Oral health status of mentallydisabled subjects in India. J Oral Scienc., 51 (3), 333-340. 5 - Seirawan, H.,Schneiderman, J., Greene, V. & Mulligan, R. (2008). Interdisciplinary approachto oral health for persons with developmental disabilities. Spec Care Dentist.,28 (2), 43-52.

Fátima Bizarra- PhD, Teacher in Oral Hygiene Department . Lisbon Portugal

Studies show that individuals with brushing dependency have

higher values of bacterial plaque2,3, the same is verified in the

current study, as well as a positive association between plaque

indexes and brushing frequency4. The same association happens in

the present investigation, in which weak correlations between the

decrease in brushing frequency and the increase in deposits and oral

hygiene rates are observed.

Regarding the type of valence, the present study found no

significant differences in OHIS and its components, with only the

deposit index (DI) values slightly lower in residents, without

agreement with another, where DI was higher among residents5.

The type of CP, brushing dependency and frequency, as well as the

number of years in institutionalization, can weigh in on the oral

hygiene and therefore on the overall oral health of this population.

INTRODUCTION & OBJECTIVE RESULTS DISCUSSION & CONSULSION

REFERENCES

The most dependent individuals, regarding tooth brushing are the ones with spastic palsy

(163; 67.6%) (p<0.001) and the ones living in the institution (120; 49.8%) (p=0.002).

MATERIALS & METHODS

47 (34.2%) twice or more a day,

120 (27.9%) once a day

148 (34.4%) never brush their teeth .

10 implemented the daily tooth brushing program

14 had the program, but no regularly

6 didn’t do the tooth brushing at all.

People that brush their teeth

twice or more a day

OHI-S (2.48, ±1.24) (p=0.001)

DI-S (1.67, ±0.59) (p=0.006)

CI-S (0.81, ± 0.78) (p<0.001)

Simplified Oral Hygiene Index (OHI-S); Simplified Debris Index (DI-S); Simplified Calculus Index (CI-S)

Values lower than the ones who do

not brush their teeth twice a day

Probability of brushing:

• At least once a day was lower in the non-

dependent (OR=0.474; p=0.001)

• In the institution at least once a day was

about twice as high in the type of mixed

paralysis (OR=2.361; p=0.043).

People who lived in the institution

DI-S=1.78 (±0.66) (p=0.210)

Lower when compared with the ones

that have homecare

(DI-S mean value is 0.21 times higher)

Dependent individuals have higher

values of OHI-S (p=0.236)