Quintessence Int 38 (2007), No. 8 26. July 2007
Quintessence Int 38 (2007), No. 8 (26.07.2007)
Page 681-687, PubMed:17823687
Assistive stabilization based on the neurodevelopmental treatment approach for dental care in individuals with cerebral palsy
Santos, Maria Theresa Botti Rodrigues/ Manzano, Felipe Scalco
Objective: To study the effects of positioning individuals with cerebral palsy (CP) on a dental chair according to the neurodevelopmental treatment (NDT) approach, to establish the best position to perform dental care in the safest and most efficient manner in such individuals.
Method and Materials: A group of 158 noninstitutionalized patients (78 males and 80 females) with CP (mean age 10.5 [SD ± 4.6]) were enrolled in the study. The behavior management techniques used were tell-show-do, voice control, assistive stabilization, oral premedication, a combination of techniques, and general anesthesia.
Results: The tell-show-do and voice control techniques were effective for only 36 (22.8%) of the patients who were collaborators: 3 presenting spastic diplegic, 23 presenting spastic hemiplegic, 4 presenting spastic double hemiplegic, and 6 presenting ataxic CP. The totality of patients with spastic quadriplegic CP, dystonic CP with athetosis, and mixed CP required all the combined forms of assistive stabilization and postural maintenance. The majority of the individuals with spastic diplegic CP required head and upper member stabilization and a mouth prop. Among the dental care treatments performed, preventive care (dental prophylaxis, sealants, and fluoride application) was performed on 78 (50.0%) patients, restorative dentistry on 40 (25.6%), and oral surgery on 38 (24.4%).
Conclusion: Present data suggest that the use of assistive stabilization was effective and permitted the dental care of individuals with CP at the outpatient clinic level, while reducing the number of patients referred for general anesthesia and ensuring better quality of life for this patient population regarding oral health.
Keywords: assistive stabilization, cerebral palsy, dental care, neurodevelopmental treatment approach, outpatient clinic