Comparison of oral findings in special needs children with and without gastrostomy.
OBJECTIVE
The objective of this study was to compare aspiration pneumonia (AP)-associated microflora, calculus, and oral hygiene/care seeking behaviors in special health care needs children (SC) with gastrostomy (GT) and without.


METHODS
Twenty-seven GT SC, ages 3 to 12 years old and matched for age and gender with 27 non-GT SC, were examined by 2 trained investigators who recorded calculus and gingival inflammation and reconciled differences. Plaque was obtained using preweighed dry paper points and saliva sampled using sterile pipettes and cultured using standard bioassay procedures in a hospital laboratory. Parent/caretakers completed a medical and oral health questionnaire.


RESULTS
No significant differences were noted for age, gender, weight, primary diagnosis, vomiting, constipation, or swallowing disorder, but GT children received 4 medications vs 1 for non-GT and were significantly more likely to have had AP, need special feeding, and drool (P < or = .05). Oral health measures were not significantly different for brushing frequency, dentifrice use, brushing problems, frequency of dental care, or gingival inflammation, but GT patients had significantly more plaque and calculus. GT patients had significantly more Haemophilus influenzae, with trends toward more gram negative enteric rods, pseudomonas, and Streptococcus pneumoniae and higher concentrations in several GT-patients and little or none in non-GT patients. GT SC had significantly less beta-streptococci than non-GT patients (P < or = .05).


CONCLUSIONS
GT SC had significantly more of 1 AP-associated organism than non-GT SC and significantly more calculus and plaque, in spite of similar care seeking and hygiene behaviors.
Jawadi
Amal H
AH
Columbus Children's Hospital, Columbus, Ohio, USA.
Casamassimo
Paul S
PS
Griffen
Ann
A
Enrile
Benedicta
B
Marcone
Mario
M
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003728:Dental Calculus / Q000145:classification; D019140:Dental Care for Children; D017742:Dental Care for Chronically Ill; D003773:Dental Plaque / Q000145:classification / Q000382:microbiology; D003802:Dentifrices / Q000627:therapeutic use; D004358:Drug Therapy; D005260:Female; D005774:Gastrostomy; D005891:Gingivitis / Q000145:classification; D006192:Haemophilus Infections / Q000145:classification; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000145:classification*; D009910:Oral Hygiene; D010342:Patient Acceptance of Health Care; D011015:Pneumonia, Aspiration / Q000382:microbiology; D012463:Saliva / Q000382:microbiology; D013290:Streptococcal Infections / Q000145:classification; D014076:Tooth Diseases / Q000145:classification*; D014099:Toothbrushing
D003802:Dentifrices