Traumatic injuries to the teeth in young individuals with cerebral palsy

The purpose of the study was to assess the characteristics of dental trauma in individuals with cerebral palsy (CP). The study group consisted of 68 individuals (36 boys and 32 girls) who visit daily a school dedicated for children with CP. Their age ranged between 7 and 21 years with a mean age of 12.6 years. The majority (74%) required a wheel chair for mobility, 13% used a walker and the others were able to walk with crutches or without aid. The parents were asked to complete a questionnaire regarding their child's age, gender, medical history, and history of dental trauma. The teeth were evaluated clinically for evidences of past injuries to the teeth, enamel defects in the permanent incisors, scars on the chin and size of overjet. Thirty-nine individuals (57%) had signs of trauma to the permanent teeth. Sixty-eight teeth, mostly the maxillary central incisors, were injured. Boys were slightly less affected than girls, 56% (20/36) and 59% (19/32), respectively. Fracture of enamel and dentine was the most common type of injury (62%). Scars on the chin were detected in 28% of the individuals but only one had fractures of the molar (primary) teeth. The overjet ranged between -3.0 and +14 mm but no correlation could be found between the size of the overjet and tendency to injure the teeth. Localized enamel defects were detected on the labial surface of 13 teeth in nine individuals, probably due to luxation injuries to the primary incisors. The prevalence of dental injuries in a group of individuals with CP was found to be much higher than that of healthy populations despite the fact that CP individuals do not take part in violent sport activities as healthy children do. This should alert caregivers to carry out a profound investigation of the events that result in dental injuries in disabled individuals and suggest methods to reduce this type of morbidity.