Association of onabotulinum toxin A treatment with salivary pH and dental caries of neurologically impaired children with sialorrhea.
BACKGROUND
Sialorrhea is a common manifestation of several neurological disorders. The use of intraglandular onabotulinum toxin A (OBTXA) injection has been recognized to effectively treat sialorrhea. As OBTXA injection reduces salivary flow rate and alters salivary quality, its use may have a detrimental effect on oral health.


OBJECTIVE
To examine the effect of OBTXA injection on caries experience and salivary pH of neurologically impaired children with sialorrhea.


METHODS
Twenty-five children receiving OBTXA treatment and 25 control children were enrolled in the study. Whole saliva was collected to determine salivary pH. All participants underwent an interview on their dietary habits. Dental clinical examinations were carried out to evaluate caries experience and oral hygiene level.


RESULTS
Overall, mean salivary pH value was significantly lower in the OBTXA group (6.92 ± 0.77) compared with the control group (7.36 ± 0.70). Caries activity was significantly higher in the OBTXA group (P = 0.01). The regression analyses showed a significant association between OBTXA treatment and salivary pH value (P = 0.03). Results from the logistic regression show that dental caries was significantly associated with OBTXA treatment (OR = 1.73, CI = 1.14-27.3).


CONCLUSIONS
The study showed an intricate relationship between OBTXA treatment and oral findings. Hence, special dental care should be given to children receiving OBTXA treatment.
Division of Dentistry, Department of Pediatric Surgery, Montreal Children's Hospital, Montreal, Quebec, Canada.
Beatriz
B
Ferraz Dos Santos
Division of Dentistry, Department of Pediatric Surgery, Montreal Children's Hospital, Montreal, Quebec, Canada.
Basma
B
Dabbagh
Department of Otolaryngology, Head and Neck Surgery, Montreal Children's Hospital, Montreal, Quebec, Canada.
Sam J
SJ
Daniel
Division of Dentistry, Department of Pediatric Surgery, Montreal Children's Hospital, Montreal, Quebec, Canada.
Stephane
S
Schwartz
D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003730:Dental Care for Persons with Disabilities; D003731:Dental Caries / Q000453:epidemiology; D019988:Children with Disabilities; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D012463:Saliva / Q000737:chemistry; D012798:Sialorrhea / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A