Salivary lead concentration in dental caries among normal and children with cerebral palsy

Dental caries and mean values of DMFT among children with cerebral palsy: a systematic review and meta-analysis

INTRODUCTION

One of the most prevalent causes of physical disability in children is cerebral palsy (CP), which is a series of complicated neurological disorders. Children with cerebral palsy suffer from multiple problems and potential disabilities, including dental caries. Hence, this study aimed to determine the pooled prevalence of dental caries and mean DMFT (Decayed, Missed, and Filled Permanent Teeth) among children with cerebral palsy in Africa and Asia.

METHODS

A comprehensive search of the literature was made to locate relevant studies in PubMed/Medline, HINARI, Web of Science, Science Direct, the Cochrane Library, the Worldwide Science Database, and Google Scholar. The data were extracted in Microsoft Excel and transferred to Stata version 17 software for further analysis. A random-effect model was employed to estimate the pooled prevalence of dental caries and the pooled mean value of DMFT among children with cerebral palsy in Africa and Asia. Heterogeneity between studies was checked using the Cochrane Q test and I2 test statistics. Sub-group analysis by continent was done, and sensitivity analysis was checked. A small study effect was checked using Egger's statistical test at the 5% level of significance.

RESULTS

In this study, 25 original studies conducted in 17 countries in Africa and Asia that fulfilled the eligibility criteria were included in the review. The overall pooled prevalence of dental caries in Africa and Asia among children with cerebral palsy was 55.6% (95% CI: 42.4, 68.8). The pooled prevalence of dental caries among children with cerebral palsy in Africa was 42.43% (95% CI: 30.39, 54.58), and it was slightly higher in Asia with 64% (95% CI: 48.32, 79.72). In the random effect model analysis, the pooled mean DMFT of dental caries in children with cerebral palsy was 2.25 (95% CI: 1.86, 2.64). The pooled mean DMFT in Africa was 1.47 (95% CI: 0.86, 2.09), and in Asia it was 3.01 (95% CI: 2.43, 3.60).

CONCLUSION

In this study, we found that children with cerebral palsy experienced an alarming rate of dental caries. In these settings, dental caries affected roughly more than half of the children with cerebral palsy. Hence, oral health promotion initiatives should target children with CP, and this group of children must receive early preventive dental care.

Plasma bisphenol a and phthalate levels in children with cerebral palsy: a case-control study

The case-control study aimed to evaluate potential sources of exposure and the plasma concentrations of bisphenol A (BPA) and phthalates in prepubertal children having cerebral palsy (CP) and healthy control. Blood samples of 68 CP and 70 controls were analyzed for BPA, di-(2-ethylhexyl)-phthalate (DEHP), mono-(2-ethylhexyl)-phthalate (MEHP), and dibutyl phthalate (DBP). BPA and DBP levels were similar in groups. The median DEHP and MEHP levels of the children with CP were significantly lower than those of the controls (p = 0.035, p < 0.001, respectively). Exposure to plastic food containers/bags, personal care hygiene products, household cleaners, wood/coal stove heating, and city water supplies were associated with increased odds of higher BPA and phthalate levels in children with CP. In conclusion, potential exposure sources for BPA and phthalates differ in children with CP and healthy controls, and children with CP are not exposed to higher levels of BPA and phthalates.

Dental Caries Risk Assessment in Children 5 Years Old and under via Machine Learning

Background: Dental caries is a prevalent, complex, chronic illness that is avoidable. Better dental health outcomes are achieved as a result of accurate and early caries risk prediction in children, which also helps to avoid additional expenses and repercussions. In recent years, artificial intelligence (AI) has been employed in the medical field to aid in the diagnosis and treatment of medical diseases. This technology is a critical tool for the early prediction of the risk of developing caries. Aim: Through the development of computational models and the use of machine learning classification techniques, we investigated the potential for dental caries factors and lifestyle among children under the age of five. Design: A total of 780 parents and their children under the age of five made up the sample. To build a classification model with high accuracy to predict caries risk in 0–5-year-old children, ten different machine learning modelling techniques (DT, XGBoost, KNN, LR, MLP, RF, SVM (linear, rbf, poly, sigmoid)) and two assessment methods (Leave-One-Out and K-fold) were utilised. The best classification model for caries risk prediction was chosen by analysing each classification model’s accuracy, specificity, and sensitivity. Results: Machine learning helped with the creation of computer algorithms that could take a variety of parameters into account, as well as the identification of risk factors for childhood caries. The performance of the classifier is almost unbiased, making it generalizable. Among all applied machine learning algorithms, Multilayer Perceptron and Random Forest had the best accuracy, with 97.4%. Support Vector Machine with RBF Kernel (with an accuracy of 97.4%) was better than Extreme Gradient Boosting (with 94.9% accuracy). Conclusion: The outcomes of this study show the potential of regular screening of children for caries risk by experts and finding the risk scores of dental caries for any individual. Therefore, in order to avoid dental caries, it is possible to concentrate on each individual by utilizing machine learning modelling.

Salivary Biomarker Levels and Oral Health Status of Children with Cerebral Palsy and Their Healthy Siblings: A Comparative Study

BACKGROUND

The dental needs of cerebral palsy children are an area of study much in need of attention. The neglect of this aspect should be rectified, and simpler diagnostic methodologies should be established and used to serve this purpose.

AIM

This study aimed to determine oral health status and salivary biomarkers (salivary flow rate, pH, buffering capacity) among children with cerebral palsy (CP), to compare their data with that of their healthy siblings, and to evaluate the relationship between salivary biomarkers and dental caries.

METHODS

A total of 30 CP children (study group) and 30 normal healthy siblings (controls) were selected between the ages of 5 and 12 years. Salivary biomarkers were assessed, and oral health status was examined.

STATISTICAL ANALYSIS

Chi-square test was used for comparison of oral health status. Unpaired t test was used to compare caries indexes (decay/filled teeth-primary dentition [dft] and decay/missing/filled teeth-permanent dentition [DMFT]) and salivary biomarkers between the groups. Pearson correlation was used to find the correlation between salivary biomarkers and caries.

RESULTS

The dft scores were significantly higher in the study group (P<0.05). The pH values and salivary flow rates were significantly lower in the study group (P<0.05 and P<0.001, respectively). There was a significant correlation between DMFT scores and salivary flow rate in the study group (P<0.05).

CONCLUSION

Low pH and low salivary flow rate might be risk factors for dental caries in CP populations; moreover, the significant correlation between DMFT score and salivary flow rate suggests that salivary flow rate could be used as a screening tool for assessing at-risk subjects in such populations.

A prospective clinical evaluation of fixed dental prostheses made of metal alloys in patients with cerebral palsy

Background

In general, the prevalence of caries and other oral and dental issues is increased in patients with disabilities, such as those with cerebral palsy. Providing appropriate dental treatment at a primary dental clinic for patients with cerebral palsy and intellectual disability, among other conditions, is challenging.

Objective

The objective of this study was to evaluate the longevity and investigate the related prognostic factors of fixed prostheses in patients with cerebral palsy.

Methods

The records of 36 cerebral palsy patients were used for collecting and analyzing data. A total of 155 prostheses made from metal alloys were finally included in this study. Annual failure rates were calculated; patient‐ and tooth‐related variables associated with prosthesis failure were assessed by a multivariate Cox‐regression analysis and frailty models to introduce random effects.

Results

The 10‐year prosthesis survival rate was 62% and the 20‐year survival rate was 36%. In terms of prosthesis‐related variables, the type of prosthesis had a significant effect, and the hazard ratio of fixed partial dentures was 2.32 times that of single‐unit crowns. In terms of patient‐related variables, the presence of epilepsy had a significant effect on survival, and the hazard ratio for comorbid epilepsy was 3.76 times that for those without comorbid epilepsy.

Conclusions

Our findings suggested that fixed prostheses placed in patients with cerebral palsy might have a particularly low survival rate in cases with comorbid epilepsy. It might also be important to consider the type and/or design of the prosthesis carefully to ensure a better prognosis.

Role of lead in dental diseases

Lead (Pb) is ubiquitous in our environment and causes many pathophysiological health effects, including dental diseases. Dental Pb levels are considered good biological indicators of environmental and occupational Pb exposure. Pb in blood and saliva causes imbalances in the growth of oral microflora. The pH of saliva decreases, interferes with and interacts with bone-seeking elements, changes oral inflammatory parameters, generates reactive oxygen species, causes oxidative damage, and delays the mineralization process, leading to dental diseases. Pb's dental diseases include periodontitis, enamel lesions and defects, fluorosis, Burton's line, and tooth loss. Environmental and physiological factors, including age, gender, tooth type and position, pregnancy and lactation, eating and drinking habits, smoking habits, and exposures from Pb-contaminated residential and occupational areas, affect the distribution of Pb in blood, bone, and saliva, which contributes to dental diseases. However, living and working in Pb free areas can prevent environmental and occupational Pb exposure. Healthy lifestyles and eating habits, prohibiting smoking and alcohol drinking, further help prevent Pb exposure. Also, the fluoridation of water, salt, and milk provide nutritional supplements of trace elements, which can help prevent teeth from absorbing Pb from the environment, thereby reducing the risk of dental diseases.

The total content of toxic elements in horsehair given the level of essential elements

Elemental status of 214 mares aged 3-7 years from 11 breeds was studied: Arabian purebred (n = 20), Bashkir (n = 20), Kabarda (n = 20), Vyatka (n = 20), Tuva (n = 19), Yakutsk (n = 30), Mezenskaya (n = 20), Thoroughbred (n = 20), Akhal-Teke (n = 20), Russian trotter (n = 15), Soviet Heavy Draft (n = 10) bred in 13 regions of Russia. The research objective is to study the content of chemical elements in hair from the horse's mane, depending on the sum of toxic elements in animal hair expressed in moles. The elemental composition of the hair was defined by atomic emission and mass spectrometry (AES and MS). Elemental composition of biosubstrates was studied by 25 indicators (Al, As, B, Ca, Cd, Co, Cr, Cu, Fe, I, K, Li, Mg, Mn, Na, Ni, P, Pb, Se, Si, Sn, Hg, Sr, V, Zn). In the studies, an estimate of the total toxic load of the horse's body (∑tox) was given as the sum of mmoles of Al, Cd, Pb, Sn, Hg, and Sr in horsehair. Based on ∑tox percentile calculations, animals were divided into three groups up to 25 percentile (n = 54) with concentrations up to 1.09 mmol/kg, within the 25 and 75 percentile limits (n = 105) and over 75 percentile (n = 55) with a concentration above 6.08 mmol/kg. As follows from the obtained results, the ∑tox indicator in the mane's hair is closely connected with the total hair mineralization. For the studied range of ∑tox values, the relationship of this indicator with 13 essential and conditionally essential chemical elements is described. Moreover, as ∑tox increases, it indicates an increase in the concentration of eleven (Ca, P, Co, Cr, Fe, I, Mn, Li, Ni, V, As) and a decrease of two elements in hair (B, Si); for six elements (K, Mg, Na, Cu, Zn, Sn), such a connection was not revealed. At ∑tox values higher than 75 percentile, a critical increase in the exchange pools of two or more toxic elements in the body was observed in 85% of cases. Intensive exchange of selenium and iodine is observed; it is expressed by an increase in the number of animals with the content of these elements in hair beyond the "physiological standard," estimated as the range of 25-75 percentile.