Cerebral Palsy and Oral Health

Year 2022, Volume: 39 Issue: 4, 1283 - 1293, 29.10.2022

Manolya İlhanlı , İlker İlhanlı , Peruze Çelenk

Abstract

Cerebral Palsy (CP) is a disease characterized by posture, motor and movement disorders, which are caused by non -progressive but permanent damage of the fetal or infant brain in the early stages of life. In addition to these disorders abnormal motion patterns, spasticity and weakness, vision and hearing problems, epilepsy, cognitive function disorders may be accompanied. Neuromuscular problems due to CP adversely affect oral health. In addition to orofacial problems, the influence of the extremities prevents the independence of the individual affected in many areas from oral hygiene to nutritional failures. Sialorrhea, dental caries, periodontal disease, bruxism, malocclusion, dental erosion, traumatic dental injuries, enamel defects, temporomandibular joint disorders and delay in dental eruption are frequently experienced in patients with CP. The aim of this study was to examine the publications related to oral health in CP patients in the literature and to compile oral health problems and methods of managing these problems in patients with CP. 'Cerebral Palsy, Oral Health, Oral, Dental, Health, Care, Hygiene, Caries, Dysphagia, Malocclusion, Bruxism, Tooth Brushing ’and combinations of these words are scanned in Turkish and English in health databases (PubMed, Cochrane, Embase, Medline and others). Studies containing at least one subject for oral health in CP patients have been included in the examination. Existing approaches and standards were investigated. The populations examined in the studies are considered to be any subtypes of the CP, to be included in our study. The references of all scanned articles were also sought and examined. As a result, CP, one of the diseases with special requirements, brings many oral health problems. These problems adversely affect the quality of life as well as the general health of the affected individual. It is important that health professionals especially dentists, patients, patients’ parents and caregivers should be aware of the oral health problems that may be encountered, should have information about protective and therapeutic methods and determine the risks and be encouraged to configure the correct treatment protocols.

Keywords

Caries, Cerebral Palsy, Dental, Hygiene, Oral Health

References

• Kırzıoğlu Z, Bayraktar C. Serebral Palsili Çocuklarda Sık Rastlanan Oral Problemler, Ağız Dışına Salya Akışı ve Tedavi Önerileri. Sdü Sağlık Bilimleri Enstitüsü Dergisi. 2018; 9(2):156-62.
• Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Executive committee for the definition of cerebral palsy. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol. 2005; 47: 571-6.
• Jan MM. Cerebral palsy: comprehensive review and update. Ann Saudi Med. 2006; 26: 123-32.
• Rosenbaum P, Stewart D. The World Health Organization International Classification of Functioning, Disability, and Health: a model to guide clinical thinking, practice and research in the field of cerebral palsy. Semin Pediatr Neurol. 2004; 11: 5-15.
• Gokkaya NK, Caliskan A, Karakus D, Ucan H. Relation between objectively measured growth determinants and ambulation in children with cerebral palsy. Turk J Med Sci. 2009; 39: 85-90.
• Sankar C, Mundkur N. Cerebral palsy-definition, classification, etiology and early diagnosis. Indian J Pediatr. 2005; 72(10): 865-8.
• Serdaroglu A, Cansu A, Ozkan S, Tezcan S. Prevalence of cerebral palsy in turkish children between the ages of 2 and 16 years. Dev Med Child Neurol. 2006; 48: 413-6.
• Livanelioglu A, Kerem Gunel M. Serebral palsi’de fizyoterapi. Ankara Yeni Ozbek Matbaası; 2009, p. 5-12.
• Sehrawat N, Marwaha M, Bansal K, Chopra R. Cerebral palsy: a dental update. Int J Clin Pediatr Dent. 2014; 7(2): 109- 18.
• Berker AN, Yalcin MS. Cerebral palsy: orthopedic aspects and rehabilitation. Pediatr Clin N Am. 2008; 55: 1209-25.
• Shevell MI, Majnemer A, Morin I. Etiologic yield of cerebral palsy: a contemporary case series. Pediatr Neurol. 2003; 28(5): 352-9.
• Jacobsson B, Hagberg G. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol. 2004; 18(3): 425-36.
• Nelson KB, Ellenberg JH. Children who “outgrew” cerebral palsy. Pediatrics. 1982; 69(5): 529-36.
• Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol. 2000; 42(12): 816-24.
• Mukherjee S, Gaebler-Spira DJ. Cerebral Palsy. In: Braddom RL (Ed.). Physical Medicine & Rehabilitation 3th. Philedelphia: Saunders Elsevier; 2007, p.1243-67.
• Diamond M, Armento M. Children with Disabilities. In: D. J. A. (Ed.). Physical Medicine & Rehabilitation Principles and Practice. 4th. Philedelphia: Lippincott Williams & Wilkins; 2005, p. 122.
• Molnar GE, Alexander MA. Pediatric Rehabilitation. Philedelphia, USA: Hanley Belfus inc;1999.
• Koman LA, Smith BP, Shilt JS. Cerebral palsy. Lancet. 2004; 363(9421): 1619-31.
• Hoyer H, Limbrock GJ. Orofacial regulation therapy in children with Down syndrome, using the methods and appliances of Castillo-Morales. ASDC J Dent Child. 1990; 57(6): 442-4.
• Yakut, A. Serebral Palside Yeni Gelişmeler. Türkiye Klinikleri. 2008;4(4): 127-38.
• Russman BS, Ashwal S. Evaluation of the child with cerebral palsy. Semin Pediatr Neurol. 2004; 11: 47-57.
• Sala DA, Grand AD. Prognosis for ambulation in cerebral palsy. Dev Med Child Neurol. 1995; 37(11): 1020-6.
• Cowan LD. The epidemiology of the epilepsies in children. Mental Retardation and Developmental Disabilities Research Reviews. 2002; 8(3): 171-81.
• Serdaroglu A, Ozkan S, Aydin K, Gucuyener K, Tezcan S, Aycan S. Prevalence of epilepsy in Turkish children between the ages of 0 and 16 years. Journal of Child Neurology. 2004;19(4): 271-74.
• Zelnik N, Konopnicki M, Bennett-Back O, Castel-Deutsch T, Tirosh E. Risk factors for epilepsy in children with cerebral palsy. European Journal of Paediatric Neurology. 2010; 14(1): 67-72.
• Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: Incidence, impairments and risk factors. Disability and Rehabilitation. 2006; 28(4): 183-91.
• Eltumi M, Sullivan PB. Nutritional management of the disabled child: the role of percutaneous endoscopic gastrostomy. Dev Med Child Neurol. 1997; 39: 66-68.
• Jan BM, Jan MM. Dental health of children with cerebral palsy. Neurosciences (Riyadh). 2016;21(4):314-318.
• Duman O, Imad FM, Kızılay F, Yucel I, Balkan S, Haspolat S. Serebral palsili hastaların işlevsel kapasitelerine göre görme sorunlarının değerlendirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi. 2005; 48: 130-5.
• Fitzgerald DA, Follett J, Asperen PPV. Assessing and managing lung disease and sleep disordered breathing in children with cerebral palsy. Paediatr Res Rev. 2009; 10(1): 18-24.
• Vega-Sanchez R, de la Luz Gomez-Aguilar M, Haua K, Rozada G. Weight-based nutritional diagnosis of Mexican children and adolescents with neuromotor disabilities. BMC Res Notes. 2012; 5: 218.
• Ceriati E, Peppo FD, Cıprandı G, Marchettı P, Sılverı M, Rıvosecchı M. Surgery in disabled children: General gastroenterological aspects. Acta Paediatr. 2006; 95: 34-7.
• Erkin G, Kacar S, Ozel S. Serebral palsili hastalarda gastrointestinal sistem ve beslenme problemleri. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2005; 51(4): 150-5.
• Dahlseng MO, Finbraten AK, Juliusson PB, Skranes J, Andersen G, Vik T. Feeding problems, growth and nutritional status in children with cerebral palsy. Acta Paediatr. 2012; 101(1): 92-8.
• Pelegano JP, Nowysz S, Goepferd S. Temporomandibular joint contracture in spastic quadriplegia: effect on oral-motor skills. Dev Med Child Neurol. 1994; 36(6): 487-94.
• Bhat M, Nelson KB. Developmental enamel defects in primary teeth in children with cerebral palsy, mental retardation, or hearing defects: a review. Advances in Dental Research. 1989; 3:132-42.
• Cohen MD, Diner H. The significance of developmental dental enamel defects in neurological diagnosis. Pediatr. 1970; 46:737-47.
• Murray GS, Johnsen DC, Weissman BW. Hearing and neurologic impairment: insult timing indicated by primary tooth enamel defects. Ear and Hearing. 1987; 8:68-73.
• Grzić R, Bakarcić D, Prpić I, Jokić NI, Sasso A, Kovac Z, et al. Dental health and dental care in children with cerebral palsy. Coll Antropol. 2011; 35: 761-4.
• Bhowate R, Dubey A. Dentofacial changes and oral health status in mentally challenged children. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2005; 23(2):71-3.
• Altun C, Guven G, Basak F, Akbulut E. Altı-onbir yaş grubu çocukların ağız-diş sağlığı yönünden değerlendirilmesi. Gülhane Tıp Dergisi. 2005; 47:114-8.
• Jones MW, Morgan E, Shelton JE. Primary care of the child with cerebral palsy: a review of system (Part II). J Pediatr Health Care. 2007; 21: 226-37.
• Faulconbridge RVL, Tranter RM, Moffat V, Green E. Review of management of drooling problems in neurologically impaired children: a review of methods and results over 6 years at Chailey Heritage Clinical Services. Clinical Otolaryngology. 2001; 26(2): 76-81.
• Lin X, Wu W, Zhang C, Lo EC, Chu CH, Dissanayaka WL. Prevalence and distribution of developmental enamel defects in children with cerebral palsy in Beijing, China. Int J Paediatr Dent. 2011; 21(1): 1-6.
• Moslemi M, Vejdani J, Sadrabad ZK, Shadkar MM. A study on the eruption timing of permanent dentition in patients with cerebral palsy. Spec Care Dentist. 2013; 33(6): 275-9.
• Inga CJ, Reddy AK, Richardson SA, Sanders B. Appliance for chronic drooling in cerebral palsy patients. Pediatric Dentistry. 2001; 23 (3):241-2.
• de Carvalho RB, Mendes RF, Prado RR, Jr. Moita Neto JM. Oral health and oral motor function in children with cerebral palsy. Spec Care Dentist. 2011; 31(2): 58-62.
• Katz CR. Integrated approach to outpatient dental treatment of a patient with cerebral palsy: a case report. Spec Care Dentist. 2012; 32(5): 210-7.
• Rodrigues dos Santos MT, Masiero D, Novo NF, Simionato MR. Oral conditions in children with cerebral palsy. J Dent Child (Chic). 2003; 70(1): 40-6.
• Santos MT, Ferreira MC, Mendes FM, de Oliveira Guaré R. Assessing salivary osmolality as a caries risk indicator in cerebral palsy children. Int J Paediatr Dent. 2014; 24(2): 84-9.
• Fairhurst CB, Cockerill H. Management of drooling in children. Arch Dis Child Educ Pract Ed. 2011; 96(1): 25-30.
• Hegde AM, Pani SC. Drooling of saliva in children with cerebral palsy-etiology, prevalence, and relationship to salivary flow rate in an Indian population. Spec Care Dentist. 2009; 29(4): 163-8.
• Tahmassebi JF, Curzon ME. The cause of drooling in children with cerebral palsy - hypersalivation or swallowing defect? Int J Paediatr Dent. 2003; 13(2): 106-11.
• Meningaud JP, Pitak-Arnnop P, Chikhani L, Bertrand JC. Drooling of saliva: a review of the etiology and management options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101: 48-57.
• Tahmassebi JF, Curzon ME. Prevalence of drooling in children with cerebral palsy attending special schools. Dev Med Child Neurol. 2003; 45(9): 613-7.
• Ortega AO, Guimarães AS, Ciamponi AL, Marie SK. Frequency of parafunctional oral habits in patients with cerebral palsy. J Oral Rehabil. 2007; 34(5): 323-8.
• Roberto LL, Machado MG, Resende VL, Castilho LS, Abreu MH. Factors associated with dental caries in the primary dentition of children with cerebral palsy. Braz Oral Res. 2012; 26(5): 471-7.
• Dougherty NJ. A review of cerebral palsy for the oral health professional. Dent Clin N Am. 2009; 53: 329-38.
• Hussein I, Kershaw AE, Tahmassebi JF, Fayle SA. The Management of Drooling in Children and Patients with Mental and Physical Disabilities a Literature Review. International Journal of Pediatric Dentistry. 1998; 8: 3-11.
• Siegel L, Klingbeil M. Control of drooling with transdermal scopolamine in a child with cerebral palsy. Dev Med Child Neurol. 1991; 33: 1013-4.
• Nunn JH. Drooling: review of the literature and proposals for management. J Oral Rehabil. 2000; 27(9): 735-43.
• Lal D, Hotaling AJ. Drooling. Curr Opin Otolaryngol Head Neck Surg. 2006; 14(6): 381-6.
• Van der Burg JJ, Didden R, Jongerius PH, Rotteveel JJ. Behavioral treatment of drooling: a methodological critique of the literature with clinical guidelines and suggestions for future research. Behav Modif. 2007; 31(5): 573-94.
• Ruscello DM. Nonspeech oral motor treatment issues related to children with developmental speech sound disorders. Lang Speech Hear Serv Sch. 2008; 39(3): 380-91.
• Johnson HM, Reid SM, Hazard CJ, Lucas JO, Desai M, Reddihough DS. Effectiveness of the Innsbruck Sensorimotor Activator and Regulator in improving saliva control in children with cerebral palsy. Developmental Medicine & Child Neurology. 2004; 46: 39-45.
• Castillo-Morales R, Brondo J, Hoyer H, Limbrock GJ. Treatment of chewing, swallowing and speech defects in handicapped children with Castillo-Morales orofacial regulator therapy: advice for pediatricians and dentists. Zahnarztl Mitt. 1985; 75(9): 935-42, 947-51.
• Hinz R. Habits and Their Prevention. Düsseldorf: HPSS-Gmbh; 1995.
• Limbrock GJ, Hoyer H, Scheying H. Drooling, chewing and swallowing dysfunctions in children with cerebral palsy: treatment according to Castillo-Morales. ASDC J Dent Child. 1990; 57(6): 445-51.
• Little SA, Kubba H, Hussain SS. An evidence-based approach to the child who drools saliva. Clin Otolaryngol. 2009; 34(3): 236-9.
• Jongerius PH, van Tiel P, van Limbeek J, Gabreëls FJ, Rotteveel JJ. Ansystematic review for evidence of efficacy of anticholinergic drugs to treatndrooling. Arch Dis Child. 2003; 88(10): 911-4.
• Bachrach SJ, Walter RS, Trzcinski K. Use of glycopyrrolate and other anticholinergic medications for sialorrhea in children with cerebral palsy. Clin Pediatr (Phila). 1998; 37(8): 485-90.
• Hanagası HA. Hipersekretuvar Bozukluklar ve Botulinum Toksini. Nöropsikiyatri Arşivi. 2010; 47: 48-51.
• Porte M, Chaléat-Valayer E, Patte K, D’Anjou MC, Boulay C, Laffont I. Relevance of intraglandular injections of Botulinum toxin for the treatment of sialorrhea in children with cerebral palsy: a review. Eur J Paediatr Neurol. 2014; 18(6): 649-57.
• Chaléat-Valayer E, Porte M, Buchet-Poyau K, Roumenoff- Turcant F, D’Anjou MC, Boulay C, et al. Management of drooling in children with cerebral palsy: A French survey. Eur J Paediatr Neurol. 2016; 20(4): 524-31.
• Koyuncuoglu HR, Demirci S. Application of botulinum toxin at a neurology clinic: an eleven-year experience. Turk J Neurol. 2016; 22: 8-12.
• Gonzalez-L MD, Martinez C, Bori Y, Fortuny I, Suso- Vergara S. Factors in the efficacy, safety, and ımpact on quality of life for treatment of drooling with botulinum toxin type a in patients with cerebral palsy. Am J Phys Med Rehabil. 2017; 96(2): 68-76.
• Reed J, Mans CK, Brietzke SE. Surgical management of drooling: a meta-analysis. Arch Otolaryngol Head Neck Surg. 2009; 135(9): 924-31.
• Nguyen DH, Martin JT. Common dental infections in the primary care setting. Am Fam Physician. 2008; 77(6): 797-802.
• Albert DA, Park K, Findley S, Mitchell DA, McManus JM. Dental caries among disadvantaged 3- to 4-year-old children in northern Manhattan. Pediatr Dent. 2002; 24(3): 229-33.
• Cardoso AM, Gomes LN, Silva CR, Soares RD, De Abreu MH, Padilha WW, et al. Dental caries and periodontal disease in Brazilian children and adolescents with cerebral palsy. Int J Environ Res Public Health. 2014; 12: 335-53.
• Botti MT, Biancardi M, Oliveira R, Jardim JR. Caries prevalence in patients with cerebral palsy and the burden of caring for them. Spec Care Dentist. 2010; 30:206-10.
• Dini EL, Holt RD, Bedi R. Prevalance of caries and developmental defects of enamel in 9-10 year old children living in Brazil with differing water fluoride histories. British Dental Journal. 2000; 188:146-49.
• Guare Rde O, Ciampioni AL. Prevalence of periodontal disease in the primary dentition of children with cerebral palsy. J Dent Child (Chic). 2004; 71(1): 27-32.
• de Oliveira R, Ciampioni AL. Prevalence of Periodontal Disease in the Primary Dentition of Children with Cerebral Palsy. J Dent Child. 2004; 71:27-32.
• Rennan Y, Colman McG, Cynthia K, Nigel M. Oral health in pres¬chool children with cerebral palsy: a case–control community-based study. International Journal of Paediatric Dentistry. 2010; 20:330-5.
• Mani SA, Mote N, Kathariya M, Pawar KD. Adaptation and development of dental procedure in cerebral palsy. Pravara Med Rev. 2015; 7(4): 17-22.
• dos Santos MT, Masiero D, Simionato MR. Risk factors for dental caries in children with cerebral palsy. Spec Care Dentist. 2002; 22(3): 103-7.
• Santos MT, Guare RO, Celiberti P, Siqueira WL. Caries experience in individuals with cerebral palsy in relation to oromotor dysfunction and dietary consistency. Spec Care Dentist. 2009; 29: 198-203.
• Dourado Mda R, Andrade PM, Ramos-Jorge ML, Moreira RN, Oliveira-Ferreira F. Association between executive/attentional functions and caries in children with cerebral palsy. Res Dev Disabil. 2013; 34: 2493-9.
• Subasi F, Mumcu G, Koksal L, Cimilli H, Bitlis D. Factors affecting oral health habits among children with cerebral palsy: pilot study. Pediatr Int. 2007; 49: 853-7.
• Jones MW, Morgan E, Shelton JE, Thorogood C. Cerebral palsy: introduction and diagnosis (Part I). J Pediatr Health Care. 2007; 21(3):146-52.
• Kosif R, Gunalp Z, Safi Oz Z. Evaluation of the dental-gingival health in children with cerebral palsy in Zonguldak. The New Journal of Medicine. 2013; 30(1):37-41.
• Gunel MK, Mutlu A, Tarsuslu T, Livanelioglu A. Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy. Eur J Pediatr. 2009; 168: 477-85.
• Cokpekin F, Koymen G, Basak F, Akbulut E, Altun C. Engelliler okuluna devam eden çocukların ağız diş sağlığı yönünden değerlendirilmesi. Gülhane Tıp Dergisi. 2003: 45(3):228-32.
• Mani SA, Mote N, Kathariya M, Pawar KD. Adaptation and development of dental procedure in cerebral palsy. Pravara Med Rev. 2015; 7(4): 17-22.
• Weisman EJ. Diagnosis and treatment of gingival and periodontal disorders in children with cerebral palsy. J Dent Child (Chic). 1956; 23: 73-80.
• Santos MT, Ferreira MC, Guaré RO, Diniz MB, Rösing CK, Rodrigues JA, et al. Gingivitis and salivary osmolality in children with cerebral palsy. Int J Paediatr Dent. 2016; 26(6): 463-70.
• Bozkurt FY, Fentoglu O, Yetkin Z. The Comparison of Various Oral Hygiene Strategies in Neuromuscularly Disabled Individuals. J Contemp Dent Pract. 2004; 4(5): 23-31.
• Mitsea AG, Karidis AG, Donta-Bakoyianni C, Spyropoulos ND. Oral health status in Greek children and teenagers, with disabilities. J Clin Pediatr Dent. 2001; 26(1): 111-8.
• Damle SG, Bhavsar JP. Plaque removing efficacy of individually modified toothbrushes in cerebral palsy children. ASDC J Dent Child. 1995; 62(4): 279-82.
• Yitzhak M, Sarnat H, Rakocz M, Yaish Y, Ashkenazi M. The effect of toothbrush design on the ability of nurses to brush the teeth of institutionalized cerebral palsy patients. Spec Care Dentist. 2013; 33(1): 20-7.
• Dogan MC, Alacam A, Asici N, Odabas M, Seydaoglu G. Clinical evaluation of the plaque-removing ability of three different toothbrushes in a mentally disabled group. Acta Odontol Scand. 2004; 62(6): 350-4.
• Santos MT, Duarte Ferreira MC, de Oliveira Guaré R, Guimarães AS, Lira Ortega A. Teeth grinding, oral motor performance and maximal bite force in cerebral palsy children. Spec Care Dentist. 2015; 35(4): 170-4.
• Zarowski M, Mojs E, Gajewska E, Steinborn B, Samborski W. Prevelance of sleep problems in children with cerebral palsy. Preliminary study. Ann. Acad. Med. Stetin. 2008; 54: 59-64.
• Miamoto CB, Pereira LJ, Ramos-Jorge ML, Marques LS. Prevalence and predictive factors of sleep bruxism in children with and without cognitive impairment. Braz Oral Res. 2011; 25(5): 439-45.
• Abanto J, Ortega AO, Raggio DP, Bönecker M, Mendes FM, Ciamponi AL. Impact of oral diseases and disorders on oral-health-related quality of life of children with cerebral palsy. Spec Care Dentist. 2014; 34(2): 56-63.
• Fonseca CM, dos Santos MB, Consani RL, dos Santos JF, Marchini L. Incidence of sleep bruxism among children in Itanhandu, Brazil. Sleep Breath. 2011; 15(2): 215-20.
• Souza VA, Abreu MH, Resende VL, Castilho LS. Factors associated with bruxism in children with developmental disabilities. Braz Oral Res. 2015; 29: 1-5.
• Lang R, White PJ, Machalicek W, Rispoli M, Kang S, Aquilar J, et al. Treatment of bruxism in individuals with developmental disabilities: a systematic review. Res Dev Disabil. 2009; 30(5): 809-18.
• Jan MM. Melatonin for the treatment of handicapped children with severe sleep disorders. Pediatr Neurol. 2000; 23: 229-32.
• Yoshida M, Nakajima I, Uchida A, Yamaguchi T, Nonaka T, Yoshida H, et al. Characteristics of lower-jaw-position sensation with respect to oral-jaw functions in patients with cerebral palsy. Pediatric Dental Journal. 2004; 14(1): 23-8.
• Miamoto CB, Ramos-Jorge ML, Pereira LJ, Paiva SM, Pordeus IA, Marques LS. Severity of malocclusion in patients with cerebral palsy: determinant factors. Am J Orthod Dentofacial Orthop. 2010; 138: 394-5.
• Franklin DL, Luther F, Curzon ME. The prevalence of malocclusion in children with cerebral palsy. Eur J Orthod. 1996; 18: 637-43.
• Henrikson T, Ekberg EC, Nilner M. Masticatory efficiency and ability in relation to occlusion and mandibular dysfunction in girls. Int J Prosthodont. 1998; 11: 125-32.
• Becker A, Chaushu S, Shapira J. Orthodontic treatment for the special needs child. Seminars in Orthodontics. 2004; 10: 281-92.
• Practical oral care for people with cerebral palsy. U.S. Department of Health and Human Services, National institutes of Health, National institute of Dental and Craniofacial Research. 2009. Available at https://www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-cerebral-palsy.pdf
• Barron RP, Carmichael RP, Marcon MA, Sandor GK. Dental erosion in gastroesophageal reflux disease. J Can Dent Assoc. 2003; 69: 84-9.
• Jarvinen VK, Rytomaa II, Heinonen OP. Risk factors in dental erosion. J Dent Res. 1991; 70(6): 942-7.
• Millward A, Shaw L, Smith AJ, Rippin JW, Harrington E. The distribution and severity of tooth wear and the relationship between erosion and dietary constituents in a group of children. Int J Paediatr Dent. 1994; 4(3): 151-7.
• Shaw L, Weatherill S, Smith A. Tooth wear in children: an investigation of etiological factors in children with cerebral palsy and gastroesophageal reflux. ASDC J Dent Child. 1998; 65(6): 484-6, 439.
• Erkin G, Kacar S, Ozel S. Serebral palsili hastalarda gastrointestinal sistem ve beslenme problemleri. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2005; 51(4): 150-5.
• Su JM, Tsamtsouris A, Laskou M. Gastroesophageal reflux in children with cerebral palsy and its relationship to erosion of primary and permanent teeth. J Mass Dent Soc. 2003; 52: 20-4.
• Goncalves GK, Carmagnani FG, Correa MS, Duarte DA, Santos MT. Dental erosion in cerebral palsy patients. J Dent Child. 2008; 75:117-20.
• Lussi A. Dental Erosion from Diagnosis to Therapy. 2nd ed. Vol 20. Switzerland, Karger; 2006, 36-41.
• Polat Z, Akgun O, Turan I, Polat GG, Altun C. Evaluation of the relationship between dental erosion and scintigraphically detected gastroesophageal reflux in patients with cerebral palsy. Turk J Med Sci. 2013; 43:283-8.
• Dahshan A, Patel H, Delaney J, Wuerth A, Thomas R, Tolia V. Gastroesophageal reflux disease and dental erosion in children. J Pediatr. 2002; 140(4): 474-8.
• Yasui EM, Kimura RK, Kawamura A, Akiyama S, Morisaki I. A modified oral screen appliance to prevent self-inflicted oral trauma in an infant with cerebral palsy: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97(4): 471-5.
• Holan G, Peretz B, Efrat J, Shapira Y. Traumatic injuries to the teeth in young individuals with cerebral palsy. Dent Traumatol. 2005; 21(2): 65-9.
• Batista C, Ramos-Jorge ML, Coelho M, De Oliveira M, Gonçalves R, Silva L. Dental trauma in individuals with severe cerebral palsy: prevalence and associated factors. Braz Oral Res. 2011; 25:319-23.
• Jaffe M, Attias D, Dar H, Eli I, Judes H. Prevalence of gestational and perinatal insults in brain-damaged children. Isr J Med Sci. 1985; 21(12): 940-4.
• Dodrill P, Gosa MM. Pediatric dysphagia: physiology, assessment, and management. Ann Nutr Metab. 2015; 66(5): 24-31.
• Lloyd Faulconbridge RV, Tranter RM, Moffat V, Green E. Review of management of drooling problems in neurologically impaired children: a review of methods and results over 6 years at Chailey Heritage clinical services. Clin Otolaryngol Allied Sci. 2001; 26: 76-81.
• Lefton-Greif MA. Pediatric dysphagia. Phys Med Rehabil Clin N Am. 2008; 19: 837-51.
• Sullivan PB, Lambert B, Rose M, Ford-Adams M, Johnson A, Griffiths P. Prevalence and severity of feeding and nutritional problems in children with neurological impairment: oxford feeding study. Dev Med Child Neurol. 2000; 42: 674-80.
• Alsaggaf AH, Jan MM, Saadah OI, Alsaggaf HM. Percutaneous endoscopic gastrostomy (PEG) tube placement in children with neurodevelopmental disabilities: parents’ perspectives. Saudi Med J. 2013; 34: 695-700.
• Yılmaz S, Basar P, Gisel EG. Assessment of feeding performance in patients with cerebral palsy. Int Journal Rehabil Res. 2004; 27(4): 325-9.
• Mathisen B, Skuse D, Wolke D, Reilly S. Oral-Motor Dysfunction and Failure to Thrive among Inner-City Infants. Developmental Medicine and Child Neurology. 1989; 31(3): 293-302.
• Morasch HS, Bartolome G. Swallowing disorders: Pathophysiology and rehabilitation of neurogenic dysphagia. NeuroRehabilitation. 1998; 10: 169-89.
• Logemann JA. Evaluation and treatment of swallowing disorders (2nd);1998.
• Park JW, Oh JC, Lee HJ, Park SJ, Yoon TS, Kwon BS. Effortful swallowing training coupled with electrical stimulation leads to an increase in hyoid elevation during swallowing. Dysphagia. 2009; 24(3): 296-301.
• Haberfellner H, Schwartz S, Gisel EG. Feeding skills and growth after one year of intraoral appliance therapy in moderately dysphagic children with cerebral palsy. Dysphagia. 2001; 16(2): 83-96.
• Cumella S, Ransford N, Lyons J, Burnham H. Needs for oral care among people with intellectual disability not in contact with Community Dental Services. J Intellect Disabil Res. 2000; 44 (1): 45-52.
• Pope JE, Curzon ME. The dental status of cerebral palsied children. Pediatr Dent. 1991; 13: 156-62.
• Suri L, Gagari E, Vastardis H. Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review. Am J Orthod Dentofacial Orthop. 2004; 126(4): 432-45.
• Miamoto CB, Pereira LJ, Paiva SM, Pordeus IA, Ramos-Jorge ML, Marques LS. Prevalence and risk indicators of temporomandibular disorder signs and symptoms in a pediatric population with spastic cerebral palsy. J Clin Pediatr Dent. 2011; 35: 259-63.
• Jan MM. Neurological examination of difficult and poorly cooperative children. J Child Neurol. 2007; 22: 1209-13.
• Wongprasartsuk P, Stevens J. Cerebral palsy and anaesthesia. Paediatr Anaesth. 2002; 12: 296-303.
• Komerik N, Kırzıoglu Z, Efeoglu CG. Zihinsel Engele Sahip Bireylerde Ağız Sağlığı. J Dent Atatürk Uni. 2012; 22(1): 96-104.
• Tesini DA, Fenton SJ. Oral health needs of persons with physical or mental disabilities. Dent Clin North Am. 1994; 38(3): 483-98.
• Ferguson FS, Cinotti D. Home oral health practice: the foundation for desensitization and dental care for special needs. Dent Clin North Am. 2009; 53: 375-87.