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Caries burden and high-risk subgroups in children and adolescents with cerebral palsy in Türkiye
Esra Tunalı1, Şeniz Karaçay2, Arda Tabancalı3
1Department of Orthodontics, University of Health Sciences, Hamidiye Faculty of Dental Medicine, Istanbul, Turkey. esrauclertunali@gmail.com.
Insights
Dental caries are highly prevalent in children with cerebral palsy (CP) in Türkiye, with a significant subgroup experiencing a much higher burden of disease. This highlights the need for targeted oral health interventions for this vulnerable population.
Area of Science:
- Pediatric Dentistry
- Public Health
- Craniofacial Health
Background:
- Cerebral palsy (CP) significantly impacts children's overall health, often including oral health.
- Assessing oral health status and caries experience in children with CP is crucial for developing targeted interventions.
- The Significant Caries (SiC) Index helps identify individuals with disproportionately high caries experience.
Purpose of the Study:
- To evaluate the oral health status of children with cerebral palsy (CP) in Türkiye.
- To determine the prevalence and severity of dental caries using ICDAS-mapped categories.
- To identify high-risk subgroups for dental caries using the Significant Caries (SiC) Index.
Main Methods:
- A cross-sectional study involving 51 children with CP.
- Clinical examination for dental caries (dft+DMFT) and lesion severity (ICDAS-mapped).
- Assessment of plaque accumulation (Silness-Löe index) and caregiver-reported oral hygiene, feeding, and dental attendance.
Main Results:
- High prevalence of ICDAS-mapped lesions (94%) and a mean dft+DMFT score of 4.12.
- The SiC value of 8.41 indicated a subgroup with a markedly higher caries burden.
- Suboptimal oral hygiene practices were noted, including infrequent brushing, use of inappropriate toothpaste, and persistent nighttime bottle use, all associated with caries.
Conclusions:
- Dental caries are highly prevalent in children with CP in Türkiye.
- A significant high-risk subgroup with concentrated caries burden was identified using the SiC Index.
- The findings underscore the need for improved oral hygiene education and targeted preventive strategies for children with CP.
Purpose:
To evaluate the oral health status of children with cerebral palsy (CP) in Türkiye and to examine the distribution of caries experience using the Significant Caries (SiC) Index to identify high-risk subgroups.
Methods:
This cross-sectional study included 51 children with CP receiving services from the Spastic Children's Foundation. Clinical examinations assessed dental caries using combined dft + DMFT scores, whilst lesion severity was evaluated using a three-category clinical classification mapped to ICDAS levels. Plaque accumulation was assessed using the Silness-Löe index. Caregivers completed structured questionnaires on oral hygiene practices, feeding habits, and dental attendance. Descriptive statistics were used. Continuous variables were expressed as mean ± SD or median (IQR). Categorical variables were expressed as frequencies and percentages with 95% confidence intervals.
Results:
ICDAS-mapped lesion prevalence was 94% and the mean dft + DMFT score was 4.12 ± 3.59. Lesion severity distribution based on ICDAS-mapped categories showed a predominance of moderate lesions. The SiC value was 8.41, indicating a subgroup with markedly higher caries burden. Although 86% had a toothbrushing habit, only 43% brushed twice daily. Of those using toothpaste, 59% used fluoride-free children's toothpaste and 34% used adult toothpaste. Nighttime bottle use persisted in 55% and all with this habit had caries. The mean plaque index was 1.25 ± 0.99. No caregiver had received oral health education.
Conclusion:
Dental caries amongst children with CP in Türkiye are highly prevalent and concentrated in a high-risk subgroup identified by the SiC.
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