SCiENTIFIC ARTICLE Oral Conditions in Children with Cerebral Palsy Maria Teresa Botti ROdrigues dos Santos, DDSe, PhD Danilo Masiero, MD, PhD Neil Ferreira Novo, DDSe, PhD Maria Regina Lorenzetti Simionato, DDSe, PhD ABSTRACT Purpose: Cerebral palsy (CP) is a major severechildhood disability and its prevalence is increasing, particularly among premature low-weight newborns. The oral conditions observed demonstrate the need for home and professional care for these individuals. This study aimed to investigate dental caries, plaque index, time of eruption, malocclusion, bruxism and motor oral skills in a group of 62 CP children (study group). Methods: The results were compared to those obtained for a control group with 67 normal chil- dren. Nonparametric statistical tests including the Mann-Whitney test, Fisher'sExact test (P), Chi- square test (Xl), and Cochran's Q test were used according to the nature of the variables studied, with the levelof significance set at P<.05. Results: The results showed a significantly higher DMFS index for CP children with permanent dentition of both sexeswhen compared to normal children. A significantly higher plaque index was also observed in the study group. A high tendency to delayed eruption of permanent molars and significantly higher percentages of malocclusion and bruxism were observed in the study group with permanent dentition. Residual food and mouth breathing have been frequently found in CP children. Conclusions: Earlier preventive measures for CP patients are required because they are a high-risk group for dental caries. (J Dent Child. 2003;70:40-46) KEYwORDS: CEREBRAL PALSY, DENTAL CARIES, ORAL HYGIENE, PLAQUE INDEX C erebral palsy (CP) belongs to the group of the most common and severe disabilities of childhood, char- acterized by a set of non-progressive motor disor- ders of posture and movement due to a lesion in the devel- oping brain. 1 The rate of CP has risen in spite of falling perinatal and neonatal mortality rates, a rise that is even more pronounced when the mildest and least reliably ascer- tained cases were excluded. The effect of modern care seems to be that many babies <2500 g who would have died dur- ing the perinatal period now survive with severe Cp'2Thus, these children need special or intensive care, requiring the interest of investigators not only in the prevention of the Dr.Rodrigues dos Santos Is full professor, Division of Dentistry for Persons w ith Disabilities, University Cruzeiro Do Sui, Sao Paulo, Brazil. Dr.Maslero Isassociate professor, Department ofOrthopaedics and Traumatology, Federal University of Sao Paulo, Brazil. Dr Novo is professor, Department of Preventltlve Medicine, Federal University of Sao Paulo, Brazil. Dr. S/m/onato Is professor, Department of Microbiology, Institute ofBiomedical Sciences, University of Sao Paulo, Brazil. Correspond w ith Dr.Simlonato at mrslmlon@lcb.usp.br disease, but also in the prevention of the problems related to it, such as dental caries. The pathogenesis of CP seems to involvefactorsoperating dur- ing pregnancy and the neonatal period. The most important pre- natal factor appears to be intrauterine infection. 3 The prevalence of the diseasehas been reported to range from 1 to 2 per 1,000 liveborns,l being significantlyhigher in males and black people. 4 - 5 The problems due to the diseaseare definitely becoming worse. The most common disorders associated with CP are mental retardation, sensory limitations, epilepsy, learning difficulties, speech disorders, and hearing loss.6There is contradictory infor- mation in the literature regarding the incidence of oral diseases in patients with Cp. According to Brown,? these controversies are due to failure of the criteria used to choose the population to be studied, absence of control groups, and use of non-standard- ized criteria for diagnosis, inexperienced investigators, and lack of statistical analysis of the results. The purpose of this study was to investigate the prevalenceof the main oral disorders, such as dental caries,plaque index, time of eruption of permanent teeth, malocclusion and bruxism in a group of children with Cp, and compare these results with those ob- tained for a control group of normal children. Oral motor skills 40 dos Santos et al Oral Conditions in Children w ith CP Journal of Dentistry for Children