Bruxism and Parafunctional Oral Habits in Children and Adolescents With Cerebral Palsy
Condition: Cerebral Palsy; Bruxism
MeSH terms: Bruxism; Paralysis; Cerebral Palsy
Study type: Observational

Summary: 
      The aim of the study is to evaluate and analyze the rates and relationships between bruxism,
      other parafunctional oral activities, and oral-motor activities in children and adolescents
      with spastic CP.
    

Detailed description: 
      This cross-sectional study was conducted on children and adolescents with CP receiving care
      services in three different private rehabilitation centers between January 2020 and March
      2021. All the parents or primary caregivers included in the study were mothers of children
      with CP. Initially, information about bruxism and parafunctional oral habits and the study's
      aims were given to the mothers. All the mothers provided written informed consent for
      voluntary participation.

      63 children and adolescents with spastic CP were analyzed, comprising 35 girls and 28 boys.

      All the children were observed in clinical environments for classification according to the
      Gross Motor Function Classification System (GMFCS) and levels of activity and communication.

      Data were collected from an evaluation form, clinical examination of the individuals, and
      interviews with the mothers.

      In the first section of the evaluation, the medical records of the children with CP were
      reviewed for demographics, and clinical data, including age, gender, CP type, medication, and
      history of epilepsy. The GMFCS was used to determine the level of impairment in gross motor
      functions of the children.

      In the second section of the evaluation, bruxism and other parafunctional oral activities
      were evaluated in detail through a face-to-face interview with each child's mother.

      Other parafunctional oral habits were both questioned and observed in the clinical
      environment. The presence of sucking habits (thumb sucking, lip-biting, nail-biting, and
      cheek biting) and the use of a pacifier for more than 24 months was noted and recorded as
      present or absent.

      The tongue-thrust reflex evaluation scale was applied for tongue thrust. Swallowing problems
      were evaluated with the water swallowing test, drooling with the saliva control problem
      severity, and frequency scale.

      The habit of chronic breathing through the mouth was evaluated through information gained
      from the mother and from observation of whether nasal or buccal breaths were taken during
      routine treatment and evaluation in the clinical environment. For the evaluation of chewing
      problems, information about feeding was obtained from the mother and recorded as difficulty
      in chewing solid food, otherwise as absent.
    

Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        The evaluation was made of 63 children and adolescents with spastic CP, comprising 34 (54%)
        females and 29 (46%) males with a mean age of 9.00±4.26 years.

        The GMFCS level distribution was determined at the highest rate of level 1 in 15 (23.8%)
        and the lowest level 5 in 9 (14.3%) children.

        Bruxism was present in 33 (52.4%) children, chronic mouth breathing in 33 (55.5%), sucking
        habits in 21 (33.3%), pacifier use for more than 24 months in 20 (31.7%), and tongue thrust
        in 13 (20.6%). The results of the oral-motor activity evaluation determined chewing
        difficulty in 35 (55.5%) children, swallowing problems in 20 (31.7%), and drooling in 23
        (36.5%).
      
Keywords: Cerebral Palsy; Children; Adolescent; Bruxism; Habits