title: Factors related to oral hygiene in persons with scleroderma.
abstract: OBJECTIVE
  The purpose of this study was to assess potential risk factors for the development of poor oral hygiene and increased dental caries in individuals with scleroderma.
  
  
  METHODS
  Twenty-two subjects with scleroderma participated in this study. All subjects were examined with the Patient Hygiene Performance (PHP) Index, which assesses the extent of plaque and debris over a tooth surface. In addition, oral aperature, xerostomia and dominant upper extremity strength, motion, skin thickness, and dexterity were measured.
  
  
  RESULTS
  None of the subjects had good or excellent hygiene. Fifteen subjects had fair oral hygiene and seven subjects had poor oral hygiene as measured by the PHP Index. Significant differences were seen between these two groups for oral aperture, percentage of teeth with caries, skin thickness, dexterity and finger flexion. Dexterity and joint motion correlated significantly with the number of decayed surfaces and number of caries. Oral aperture correlated with the PHP Index and the number of dental caries.
  
  
  CONCLUSIONS
  Subjects with poor oral hygiene required more time to complete manual dexterity task and had decreased hand strength and joint motion. Moreover, these same subjects had more contractures, scars, ulcers, and higher skin scores (more disease activity) than subjects in the fair hygiene group. In addition to frequent dental exam and routine cleaning, dental personnel may want to consider exercises to increase oral aperature and investigate toothbrush and dental floss selection used by persons with scleroderma.
authors.affiliation: Occupational Therapy Graduate Program, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131-0001, USA. jpoole@salud.unm.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Poole
authors.forename: C
authors.initials: C
authors.lastname: Brewer
authors.forename: K
authors.initials: K
authors.lastname: Rossie
authors.forename: C C
authors.initials: CC
authors.lastname: Good
authors.forename: C
authors.initials: C
authors.lastname: Conte
authors.forename: V
authors.initials: V
authors.lastname: Steen
mesh_terms: D003731:Dental Caries / Q000517:prevention & control; D003773:Dental Plaque / Q000628:therapy; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000033:anatomy & histology; D009910:Oral Hygiene; D045743:Scleroderma, Diffuse / Q000150:complications* / Q000503:physiopathology; D045745:Scleroderma, Limited / Q000150:complications* / Q000503:physiopathology; D034941:Upper Extremity / Q000503:physiopathology; D014987:Xerostomia / Q000175:diagnosis