THE INFLUENCE OF OROMOTOR FUNCTIONS AND DIET CONSISTENCY ON CARIES EXPERIENCE AND GROWTH RATE IN CEREBRAL PALSIED INDIVIDUALS
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Authors: Maria Teresa Botti Rodrigues Santos, Maria Cristina Duarte Ferreira, Paula Celiberti and Renata Oliveira Guare
Abstract: Cerebral palsy (CP) describes a group of movement and posture development disorders attributed to non-progressive disturbances in the developing fetal or infant brain, causing activity limitations and being the most common cause of severe physical disability in childhood. The motor disorders of CP are often accompanied by disturbances of sensation, cognition, communication, perception, behavior, and seizure disorders.[1] Oromotor dysfunction and oral-ingestive problems, as uncoordinated control mechanisms of orofacial and palatolingual musculatures[2], are often observed in CP individuals, and varies from mild to severe.[3] These disabilities are expressed by drooling, coughing, choking, rejection of solid food, food loss, and spillage during eating. Difficulties in spoonfeeding, biting, chewing, cup drinking, straw drinking, swallowing and clearing are also observed.[2] Another nutritional issue to be considered is the common inability of severely oromotor impaired CP individuals to ingest solid food, which often leads to an exclusively liquid or semi-solid diet. In spite of contributing to some degree to growth and nutritional disturbances, especially at an early age, food consistency may also cause a significant impact on oral health. Therefore, a timely nutritional rehabilitation and preventive measures in oral health may significantly improve the quality of life of these individuals,[4-6] as well as prevent deleterious and noxious habits such as bottle feeding. Performing an adequate oral hygiene on CP individuals however, can be a very difficult task for the caregivers, due to the patient’s persistent pathological biting reflex.[7] Food consistency, sugared beverages, and long term oral medicines[4,8], associated with oromotor dysfunction and oral hygiene difficulties, may explain the high incidence of caries and periodontal diseases exhibited by the CP population.[9-13] The influence of oromotor impairment in CP individuals as a risk factor in caries experience was not studied yet. Therefore, this study aimed at evaluating the influence of oral motricity and diet consistency on caries experience and growth rate in CP individuals.
