Serebral Palsili Çocuklarda Sık Rastlanan Oral Problemler, Ağız Dışına Salya Akışı ve Tedavi Önerileri

Serebral palsi (SP), fetal ya da yeni doğanda, gelişimini sürdürmekte olan beyin dokularında meydana gelen, ilerleyici olmayan, postür bozukluğuna yol açan, hareketi kısıtlayan, kalıcı bir grup hastalıktır. SP'ye özgü nöromüsküler problemler, farklı yollarla ağız sağlığını etkilemektedir. Diş hekiminin SP’li bireylerle ilgili sıklıkla karşılaşabileceği oral problemler arasında; bruksizm, dental erozyon, maloklüzyon, travmatik diş yaralanmaları, periodontal hastalık, diş çürükleri ve mine defektleri bulunmaktadır. Bu derlemede, SP’li çocuklarda yaygın görülen oral problemler, ağız dışına salya akışı ve tedavi önerileri ile birlikte diş hekimlerinin yaklaşımı, hasta ve ebeveyn/bakıcılarına tavsiyeleri hakkında bilgi verilmektedir.

Anahtar Kelimeler:

Serebral Palsi, Çocuk Diş Hekimliği, Oral Hijyen

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1. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol 2005;47(8):571-6.
2. Sankar C, Mundkur N. Cerebral palsy-definition, classification, etiology and early diagnosis. Indian J Pediatr 2005;72(10):865-8.
3. Serdaroğlu 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.
4. Sehrawat N, Marwaha M, Bansal K, Chopra R. Cerebral palsy: a dental update. Int J Clin Pediatr Dent 2014;7(2):109-18.
5. Berker AN, Yalcin MS. Cerebral palsy: orthopedic aspects and rehabilitation. Pediatr Clin N Am 2008;55:1209-25.
6. Jacobsson B, Hagberg G. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol 2004;18(3):425-36.
7. 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.
8. 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.
9. Tahmassebi JF, Curzon ME. Prevalence of drooling in children with cerebral palsy attending special schools. Dev Med Child Neurol 2003;45(9):613-7.
10. 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.
11. 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.
12. 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.
13. Dougherty NJ. A review of cerebral palsy for the oral health professional. Dent Clin N Am 2009;53:329-38.
14. Ferreira de Camargo MA, Frias AC, Antunes JL. The incidence of dental caries in children and adolescents who have cerebral palsy and are participating in a dental program in Brazil. Spec Care Dentist 2011;31(6):210-5.
15. 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.
16. 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.
17. Kublay S. Nörogelişimsel bozukluğu olan çocuklarda oral motor terapi sonuçları [Yüksek Lisans Tezi]. Bolu, Abant İzzet Baysal Üniversitesi, 2007; s.49-51.
18. Yılmaz YŞ. Zihinsel engelli çocuklarda salya kontrolünün sağlanmasında oral motor terapinin etkililiği [Yüksek Lisans Tezi]. Konya, Selçuk Üniversitesi, 2011; s.79.
19. 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.
20. Korbmacher H, Limbrock J, Kahl-Nieke B. Orofacial development in children with Down's syndrome 12 years after early intervention with a stimulating plate. J Orofac Orthop 2004;65(1):60-73.
21. Polat S. Orofasiyal Kas Disfonksiyonu Olan Engelli Çocuklarda Castillo-Morales Apareyinin Konuşma Gelişimi Üzerine Etkisi [Doktora Tezi]. Ankara, Gazi Üniversitesi, 2007; s.115-116.
22. Alaçam A, Kolcuoğlu N. Effects of two types of appliances on orofacial dysfunctions of disabled children. Brıt J Dev Dısabıl 2007;53(2):111-23.
23. 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.
24. 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.
25. 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.
26. Koyuncuoğlu HR, Demirci S. Application of botulinum toxin at a neurology clinic: an eleven-year experience. Turk J Neurol 2016;22:8-12.
27. 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.
28. Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001;28(12):1085-91.
29. Veiga N, Ângelo T, Ribeiro O, Baptista A. Bruxism – Literature review. Int J Dent Oral Health 2012;1(5):1-5.
30. Souza VA, Abreu MH, Resende VL, Castilho LS. Factors associated with bruxism in children with developmental disabilities. Braz Oral Res 2015;29:1-5.
31. 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.
32. 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.
33. 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.
34. Pham, EM. Pediatric Dentists’ Recommendations for Mouthguards in Patients with Cerebral Palsy [Yüksek Lisans Tezi]. Chicago, Illinois Üniversitesi, 2013; s.37-39
35. 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.
36. Amerongen AV, Veerman EC. Saliva--the defender of the oral cavity. Oral Dis 2002;8(1):12-22.
37. 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 2016b;26(6):463-70.
38. Santos MT, Diniz MB, Guaré RO, Ferreira MC, Gutierrez GM, Gorjão R. Inflammatory markers in saliva as indicators of gingival inflammation in cerebral palsy children with and without cervical motor control. Int J Paediatr Dent 2016a;26:1-8.
39. Doğan MC, Alaçam A, Aşici N, Odabaş M, Seydaoğlu 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.
40. 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.
41. 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.
42. 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.
43. 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.
44. 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(3):761-4.
45. Jones MW, Morgan E, Shelton JE, Thorogood C. Cerebral palsy: introduction and diagnosis (Part I). J Pediatr Health Care 2007;21(3):146-52.
46. Goncalves GK, Carmagnani FG, Correa MS, Duarte DA, Santos MT. Dental erosion in cerebral palsy patients. J Dent Child 2008;75:117-20.
47. Lussi A. Dental Erosion From Diagnosis to Therapy. 2nd ed. Vol 20. Switzerland, Karger, 2006;36-41.
48. Polat Z, Akgün Ö, Turan İ, 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.
49. Guaré RO, Ferreira MC, Leite MF, Rodrigues JA, Lussi A, Santos MT. Dental erosion and salivary flow rate in cerebral palsy individuals with gastroesophageal reflux. J Oral Pathol Med 2012;41(5):367-71.