title: Gingivitis and salivary osmolality in children with cerebral palsy.
abstract: OBJECTIVE
  To investigate the influence of salivary osmolality on the occurrence of gingivitis in children with cerebral palsy (CP).
  
  
  METHODS
  A total of 82 children with spastic CP were included in this cross-sectional study. Oral motor performance and gingival conditions were evaluated. Unstimulated saliva was collected using cotton swabs, and salivary osmolality was measured using a freezing point depression osmometer. Spearman's coefficient, receiver operating characteristic (ROC), and multiple logistic regression analyses were performed.
  
  
  RESULTS
  Strong correlation (r > 0.7) was determined among salivary osmolality, salivary flow rate, visible plaque, dental calculus, and the occurrence of gingivitis. The area under the ROC to predict the influence of salivary osmolality on the occurrence of gingivitis was 0.88 (95% CI 0.81-0.96; P < 0.001). The cutoff value of 84.5 for salivary osmolality presented good sensitivity and specificity, both higher than 77%. The proportion of children presenting salivary osmolality ≤84.5 mOsm/kgH2O and gingivitis was 22.5%, whereas for the group presenting osmolality >84.5 mOsm/kgH2O, the proportion of children with gingivitis was 77.5%. Salivary osmolality above 84.5 increased the likelihood of gingivitis fivefold, whereas each additional 0.1 mL of salivary flow reduced the likelihood of gingivitis by 97%.
  
  
  CONCLUSIONS
  Gingivitis occurs more frequently in children with CP showing increased values of salivary osmolality.
authors.affiliation: Individuals with Special Needs, Institute of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil. drsantosmt@yahoo.com.br.
authors.forename: Maria Teresa Botti Rodrigues
authors.initials: MT
authors.lastname: Santos
authors.affiliation: Pediatric Dentistry, SENAC, São Paulo, Brazil.
authors.forename: Maria Cristina Duarte
authors.initials: MC
authors.lastname: Ferreira
authors.affiliation: Pediatric Dentistry, Institute of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil.
authors.forename: Renata Oliveira
authors.initials: RO
authors.lastname: Guaré
authors.affiliation: Pediatric Dentistry, Institute of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil.
authors.forename: Michele Baffi
authors.initials: MB
authors.lastname: Diniz
authors.affiliation: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Cassiano Kuchenbecker
authors.initials: CK
authors.lastname: Rösing
authors.affiliation: Pediatric Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Jonas Almeida
authors.identifier: http://orcid.org/0000-0001-8887-2329
authors.initials: JA
authors.lastname: Rodrigues
authors.affiliation: Pediatric Dentistry, APCD, São Paulo, Brazil.
authors.forename: Danilo Antonio
authors.initials: DA
authors.lastname: Duarte
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D003430:Cross-Sectional Studies; D019988:Children with Disabilities; D005260:Female; D005891:Gingivitis / Q000209:etiology*; D006801:Humans; D008297:Male; D009994:Osmolar Concentration; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry*; D012680:Sensitivity and Specificity