121 - Interprofessional Collaboration for Care of Children with Severe Neurological Impairment (SNI)

Purpose: The aim of this interdisciplinary cross-sectional study was to determine the oral health of children with SNI and to correlate their oral health variables with their medical data. Parental perceptions of oral issues were also investigated.

Methods: Children with SNI aged 0-16 years were recruited. A parental questionnaire investigated previous dental experience, oral hygiene habits, diet and perceived barriers to care. The examination determined DMFT+dmft, Simplified Oral Hygiene Index (OHI-S) and treatment need. Oral health data was correlated with medical findings including feeding and hospital admissions.

Results: Forty-two children were recruited [Age-Mean(SD)=8.6(4.5); Female=55%; cerebral palsy=45%, genetic condition 55%; enteral feeding 57%] and all completed the questionnaire. Thirty-eight children attended for dental examination. 24% participants had never seen a dentist and 48% reported no previous treatment. Mean(SD) DMFT+dmft was 0.46(1.6). There was no statistically significant difference in DMFT+dmft or OHI-S of those enterally-fed versus orally-fed, or children with increased hospital admissions ( < 5 or ≥5 days/nights). Enterally-fed children had a significantly higher Calculus Index (C-I) than those orally-fed (z=2.3, P=.02). Most parents (81%) reported toothbrushing difficulty and 64% brush less than twice daily. A common reported barrier to dental care was the limited availability of dental centres/units willing to accept special needs patients.

Conclusions: Children with SNI had a mean dmft+DMFT of 0.46. There is no statistically significant difference in DMFT+dmft in children enterally-fed or those with increased hospital admissions. Calculus is significantly higher in enterally-fed children compared to those orally-fed. Additional support is required for these vulnerable children.

 

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