Hallett K B, Lucas J O, Johnston T, Reddihough D S, Hall R K
Department of Child Development and Rehabilitation, Royal Children's Hospital, Australia.
Spec Care Dentist. 1995 Nov-Dec;15(6):234-8. doi: 10.1111/j.1754-4505.1995.tb00524.x.
Drooling occurs commonly in children with cerebral palsy (CP). Surgical procedures, known as slalodochoplasties, are often performed for the control of drooling. These include major salivary gland excision, parasympathetic nerve section, duct ligation, and duct re-routing. Alterations in saliva amount, flow, and consistency occur following sialodochoplasty, and the resultant effect on dental homeostasis requires further investigation. This controlled study investigated 19 children with CP following sialodochoplasty (surgery group) and 75 children with CP treated nonsurgically (control group) who attended our hospital. Dental caries experience-including dmft, DMFT, and partial DMFS scores of mandibular incisors and canines only-plaque index, and enamel developmental defects index were recorded. Saliva buffering capacity and bacterial counts were assessed. The surgical group (median DMFT = 5.00) had significantly more dental caries when compared with the control group (median DMFT = 0.00), Wilcoxon Signed-rank Test, P < 0.0001. This study has shown that children with CP following sialodochoplasty have increased risk of dental caries when compared with those treated nonsurgically for drooling. Although no caries predictors were identified, alterations to the caries-protective role of saliva are considered the likely cause. Children who undergo this procedure should receive intensive pre- and postsurgical preventive dental therapy.
流口水在脑瘫（CP）患儿中很常见。涎管成形术等外科手术常被用于控制流口水。这些手术包括大唾液腺切除、副交感神经切断、导管结扎和导管改道。涎管成形术后唾液的量、流速和黏稠度会发生改变，其对牙齿内环境稳定的最终影响需要进一步研究。这项对照研究调查了我院收治的19例接受涎管成形术的脑瘫患儿（手术组）和75例接受非手术治疗的脑瘫患儿（对照组）。记录龋齿经验，包括仅下颌切牙和尖牙的dmft、DMFT以及部分DMFS评分、菌斑指数和釉质发育缺陷指数。评估唾液缓冲能力和细菌计数。与对照组（中位数DMFT = 0.00）相比，手术组（中位数DMFT = 5.00）的龋齿明显更多，Wilcoxon符号秩检验，P < 0.0001。这项研究表明，与接受非手术治疗流口水的脑瘫患儿相比，接受涎管成形术的脑瘫患儿患龋齿的风险增加。尽管未确定龋齿预测因素，但唾液的防龋作用改变被认为是可能的原因。接受该手术的儿童应在术前和术后接受强化预防性牙科治疗。
