Orofacial dysfunctions, drinking regimen and quality of life--long-term prospective study

The care for mentally ill patients with combined impairment deals with orofacial dysfunctions of the mentally ill, especially children suffering from Down syndrome and cerebral palsy. Objective of the study was to assess urine fluoride excretion in disabled patients with orofacial dysfunctions in relation to prevention of dental caries. The urine fluoride concentrations in disabled people were analysed to assess their fluoride exposure and possibly preventive contribution of fluoride intake. The patients for the study were recruited from the clients of three day-stay establishments from two regions in the Czech Republic. All the clients from the selected establishments were examined except for a small number of clients, whose statutory representatives (usually parents) did not agree with oral examination. Signed informed consents were obtained from the statutory representatives of all the examined patients. Totally 95 mentally disabled patients were examined with the mean age of 11.8 years (ranging from 6 months to 28 years) for orofacial dysfunctions using the Castillo Morales concept. Fluoride concentrations were measured by fluoride-selective electrode. The urine density was measured by means of hydrostatic weighing. The above-mentioned analytical methods were chosen since urine density reflects the overall liquids intake by the person and the fluoride excretion by the urine reflects its intake from all environmental sources. Atypical swallowing act was found in 98% of the cohort. Mean urine density was 1.038 g/ml ranging from 1.002 to 1.069 (77 samples). The mean urine fluoride concentration was 0.816 mg/l ranging from 0.045 to 3.225 (82 samples). Orofacial dysfunctions decrease the quality of life. Among other aspects, they influence liquids intake due to an impaired swallowing act. Moreover, patients are often dependent on the assistance of the other persons.