الفهرس 
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Abstract
Children with cerebral palsy (CP) display the same oral diseases as healthy persons. However, they present a higher susceptibility to several oro-dental diseases. The aim of this study was to assess and compare the oral health status in cerebral palsy and healthy children and relate it to the degree of the neuromuscular deficit.
The study included 87 children diagnosed with cerebral palsy that were recruited from Alexandria University Children’s Hospital (AUCH) and its outpatient-clinics (Neurology and Physical Medicine) and from different institutions (Fairhaven school and Vision institution). This group was compared to 84 healthy children selected from siblings of children attending the Pediatric Dental Clinic, Pediatric Dentistry and Dental Public Health department, Faculty of Dentistry, Alexandria University. The age of children ranged from 3-13 years.
Data were gathered by questionnaire, in addition to clinical examination. Data collected included socio-demographic variables, medical history, history of previous dental visits, oral hygiene habits, snacking habits, dietary consistency as well as chewing, swallowing and drooling problems.
Cerebral palsy children were examined under good illumination while they were lying on the examination table or on their parent’s lap or on their wheelchair and healthy children were examined on the dental chair. Although the examination was noninvasive, the examiner used universal precautions for infection control using disposable diagnostic sets including gloves, mirror, explorer and sterilized gauze to clean and dry teeth.
Caries experience was assessed according to World Health Organization (WHO) criteria. Oral hygiene was recorded using Silness and Loe Plaque Index while gingival condition was assessed according to Loe and Silness Gingival Index. Other oral conditions as bruxism, oral soft and hard tissue injuries, oral infections and occlusion were also recorded.
It was found that less number of CP children had significantly visited the dentist in the previous years compared to healthy ones. Most cerebral palsy children received dental care in private dental clinics while most of healthy children received dental treatment in university and public hospitals. In addition, most of the cerebral palsy children did not brush their teeth and needed more supervision upon tooth brushing than the healthy children.
Regarding the snacking habits, cerebral palsy children ate snacks significantly less than healthy children. Moreover, cerebral palsy children preferred juices more than healthy children whereas healthy children preferred sweets. Concerning the food consistency, (42.5%) of cerebral palsy children ate food that is either in a liquid or semisolid consistency in comparison to healthy children who ate all types of foods including solids.
Problems during chewing and swallowing in addition to drooling of saliva were significantly more frequent among cerebral palsy children than healthy children as reported by their parents.
In children with primary dentition, the mean (dmft) of the CP children was lower than that of controls with a statistically significant difference between both groups. In mixed dentition, there was no significant difference between both groups regarding the (dft). However, there was a significant difference between both groups regarding (DMFT) that was higher in CP children than healthy ones. In the permanent dentition, (DMFT) was also higher in CP children compared to healthy children but without significant difference.
The gingival condition of cerebral palsy children in the current study was significantly poorer than healthy children. Regarding the plaque accumulation, it was higher in CP children than healthy ones but with no significant difference between both groups. Tooth attrition, which was considered an indicator of bruxism, was observed only in CP children. Oral infections and soft and hard tissue injuries showed no significant difference between cerebral palsy and healthy children.
Cerebral palsy children had more class II cuspid relationship than healthy children. Convex facial profile was observed more in CP children than healthy control. Moreover, increased overbite and overjet as well as anterior open bite were observed in cerebral palsy children more than healthy children. Cerebral palsy children with level IV, V GMFCS were prone to have dental caries (dmft, dft), drooling, poor gingival condition, convex facial profile, anterior open bite more than children with level I, II, III GMFCS levels.