Association of Caries Experience and Risk Factors in Special-Needs Children

Objectives: To associate caries risk factors and experience in children with special needs in a Brazilian population.
Methods: Two-hundred 4-12 year-old children, both genders (110 boys; 90 girls) treated at 2 different Dental Schools in northeast Brazil, were selected to participate in this study. Systemic, oral health status and caries risk factors were assessed by a questionnaire. A calibrated dentist (intra-examiner Kappa=0.923) using the International Caries Detection and Assessment System (ICDAS) evaluated caries experience. For the purpose of this study, “caries index” or “CI” was identified as the sum of all ICDAS codes for all teeth per child divided by the number of teeth; “ICDAS_{4 - 6}S” referred to carious dental surfaces with codes 4 – 6; “ICDAS_1-3/4-6T” referred to carious teeth with codes 1–3 and 4–6; and “ICDAS_4-6 LRT” for lost/restored teeth with codes 4–6. Data was analyzed with Kruskal-Wallis and Mann-Whitney tests. A logistic regression analysis was applied. Values of p≤0.05 were considered significant.
Results: Caries experience differed among children in the presence of the following variables: habit of checking oral hygiene (ICDAS CI, p=0.03; ICDAS_4-6S, p=0.03), flossing (ICDAS CI, p= 0.006; ICDAS_4-6S , p=0.01; ICDAS_1-3/4-6T, p= 0.009), diet rich in sugar (ICDAS_{4 - 6}S, p=0.01), food consistency (ICDAS_4-6 LRT, p=0.03) and bottle use (ICDAS CI, p=0.02; ICDAS_4-6S, p=0.01). Brain injury (x²=8.995 presence, OR=0.196 , p=0.003) , limited range of motion (x²=5.749 presence, OR=3.691, p=0.016) and bad oral habits (presence x²=17.925, OR=4.272, p<0.001) were identified as caries-risk factors.
Conclusions: Specific factors, which must receive attention, may increase caries risk in children with special needs. In the present study these factors included inspection of the child’s oral hygiene by parents, use of dental floss, sugar consumption, food consistency and bottle use. Children with brain injuries and limited range of motion must be given special attention.