Difficulty in Keeping Teeth Clean and Its Impact on Oral Health in Cerebral Palsy: Evidence From a New Zealand Cohort

BACKGROUND: Children with cerebral palsy (CP) face challenges in maintaining oral hygiene; data on their oral health practices and outcomes are limited. AIM: To examine oral health practices and their association with adverse oral health outcomes among children and young adults with cerebral palsy in New Zealand. DESIGN: A cross-sectional, observational survey of 90 individuals with CP (aged 0-26 years) collected data on oral health behaviours, experiences, Gross Motor Function Classification System (GMFCS) and Eating and Drinking Ability Classification System (EDACS). RESULTS: Sixty-one (69%) reported teeth-brushing twice a day, 84 (94%) using age-appropriate fluoride toothpaste and 73 (85%) seeing a dental professional in the last 2 years. Difficulty keeping teeth clean was reported by 36 (41%) of participants and associated with 'poor' oral health (p < 0.001); toothache ≤ 12 months (p = 0.032); bad breath (p < 0.001) and bleeding gums ≤ 4 weeks (p < 0.001). Difficulty keeping teeth clean was more commonly reported for participants classified as GMFCS IV-V [19 (59%), p = 0.005] and EDACS III-V [12 (60%), p = 0.034]. CONCLUSION: Difficulty keeping teeth clean was commonly reported by individuals with greater physical and swallowing limitations and observed with indicators of adverse oral health. Targeted, family-centred strategies are needed to support effective oral hygiene in this population.