Influence of Diet and Oral Hygiene on Dental Caries Prevalence of Children with Cerebral Palsy

Objective: To compare the prevalence of dental caries in deciduous and mixed dentition, the oral hygiene index and the diet of institutionalized and non-institutionalized children with cerebral palsy; to verify the influence of the diet and of the oral hygiene in the caries incidence and to describe the economic factor of the non-institutionalized children. Methods: A cross-sectional study involving thirty-three institutionalized and thirty-seven non-institutionalized children defined the groups of study I and II respectively. The groups have been subdivided by age, for evaluation of the DMFT and dmft. Information related to the daily oral hygiene, the 3-day food record, the social and economic factors and the feeding dysfunction has been obtained. After the exam in a clinic environment, the analysis of the questionnaires and of the daily diet, the data have been analyzed statistically. For comparison between groups regarding age, we used the Student t test for independent samples. The difference between groups in respect to oral hygiene and eating disorders has applied the chi-square or Fisher exact test (where expected values were >5). The comparison between groups, as well as assessing the influence of frequency of brushing, flossing, fluoride toothpaste, the fact of receiving aid for oral hygiene and diet, was performed using the Mann-Whitney test. The evaluation of the degree of eating disorders in DMFT, dental plaque, calculus and OHI-S was performed using the Kruskal-Wallis. All results were considered significant for the probability of significance at 5% (p<0.05). The intraexaminer was assessed using the kappa index (89.1% and 94,6%). Results: The results showed lower values for group I of DMFT and dmft and OHI-S than the group II. Only the values to the DMFT (3-6 years old=0) was equal for both groups. The sugar intake index was 22 for group I e 8.6 for group II. The evaluated feeding dysfunction has demonstrated dysfunction in group-I (GI=54%) and the group II (GII=81.9%). Group-II was consisted of 51.45% of class C and 35.1% of class D. The rate of oral hygiene and of sugar consumption has not demonstrated any relation to the rates of dental caries in both groups. Regarding the diet, the feeding alterations found together with the motor alterations inherent to the disease have influenced the OHI-S score in the entire studied sample. Conclusion: The alteration of the diet and the education of the parents and the responsible ones regarding the oral health should be the objective of all of those who work with patients with cerebral palsy.