Comparison of oral findings in special needs children with and without gastrostomy

Area of Science:

• Pediatric Dentistry
• Oral Microbiology
• Special Needs Care

Background:

• Aspiration pneumonia (AP) is a serious concern in children with special healthcare needs (SC).
• Gastrostomy (GT) tubes are often used for nutritional support in these children, potentially altering oral microflora.
• Understanding the oral health status and microflora in children with GT tubes is crucial for preventing AP.

Purpose of the Study:

• To compare AP-associated microflora, calculus, and oral hygiene behaviors in children with and without gastrostomy (GT) tubes.
• To identify risk factors for AP in children with special healthcare needs.

Main Methods:

• A case-control study involving 27 children with GT tubes and 27 matched controls (ages 3-12).
• Oral examinations for calculus and gingival inflammation were conducted.
• Saliva and plaque samples were collected for microbial culturing.
• Parent/caretaker questionnaires assessed medical history and oral hygiene practices.

Main Results:

• Children with GT tubes had significantly more plaque and calculus.
• GT group showed higher prevalence of AP and need for special feeding.
• Microbiologically, GT patients had more Haemophilus influenzae and trends towards more gram-negative enteric rods and Streptococcus pneumoniae.
• Despite similar brushing frequency and dental care visits, GT patients had poorer oral hygiene indicators.

Conclusions:

• Children with GT tubes exhibit increased calculus, plaque, and specific AP-associated bacteria compared to non-GT peers.
• These oral health differences exist even with comparable oral hygiene and care-seeking behaviors.
• Findings suggest a need for targeted oral care interventions for children with GT tubes to mitigate AP risk.