Cerebral Palsy Research Paper
Cerebral Palsy Research Paper
Cerebral Palsy Research Paper
Audrey Noonan
Dental Hygiene IV
In the dental field we encounter all kinds of patients, ranging from normal healthy
accommodate every type of patient we encounter and cater to their specific needs. For
my research paper I chose to take a closer look at patients with cerebral palsy and the
oral implications it has on those affected by it. Cerebral palsy is a condition that is
caused when part of the brain has been injured causing paralysis or disfunction of motor
functions throughout the body. Cerebral palsy has been proven to “affect movement and
Cerebral Palsy was first documented in 1853, by Dr. William John Little, however
it was called Little’s Disease or Cerebral Paralysis at that time. The name “Cerebral
Palsy” did not come about until 1887 when Sir William Osler conducted his own
research while also referencing Little’s work. While initial research was conducted in the
1800s, there are signs that the earliest case of cerebral palsy was actually much earlier.
A medical examination of a mummified Egyptian Pharaoh found the body had extremely
deformed feet, making it the oldest physical evidence of cerebral palsy in history,
As previously stated, cerebral palsy is acquired when the brain has been injured.
The most common occurrence is during pregnancy or after birth. It can also be acquired
more common to see African American infants having a higher risk of cerebral palsy
than Caucasian infants. The cause of this statistic is unknown. It is believe that low birth
weight, prenatal care, and maternal education could be contributing factors. The earlier
a baby is born, the lower their birth rate will be, and this will put them at a higher risk of
developing cerebral palsy. In the United States of America, the rate of babies being
diagnosed with cerebral palsy is 3 to 1,000 babies and approximately 764,000 children
Cerebral palsy effects how a person is able to move their body. The symptoms
can range from minimal to severe. For example, the paralysis can include one side of
the body, or it can be paralysis of certain parts of the body. And while cerebral palsy is
affecting the physical state of the person possessing it, it is also affecting the cognitive
state of the person as well. Patients with cerebral palsy may experience a delay in
language skills, ability to comprehend reading and writing, and difficulty focusing or hold
attention for long periods of time. Cerebral palsy is not a disease or syndrome. It has no
cure, but luckily it is also not progressive, meaning that it will not get worse over time.
People with cerebral palsy are most likely taking a regimen of medications to
treat or relieve symptoms. The four main drug types you may see a patient with cerebral
inflammatory medications. The anticholinergic drugs help control muscle spasms. The
anticonvulsants help with epileptic episodes. The antidepressants are used for
depression but also have shown that they can treat muscles spasms as well. The anti-
inflammatory medications help relieve a cerebral palsy patient of their pain. These
medications are most often used together to help treat multiple symptoms at once. Side
effects of these drugs may include constipation and urinary incontinence. While these
medications are very beneficial in treatment of a patient with cerebral palsy, they do
have side effects that effect a patient’s oral health. The side effects include xerostomia,
When it comes to the oral care of a patient with cerebral palsy, special
accommodations may be needed in order for the patient to receive the best care.
Patients may present with worn down teeth due to grinding, fractured teeth due to
accidental falls, and dental decay due to their restricted ability to chew and the nature of
their diet being mostly soft foods (Hebl, 2022). Soft diets cause patients to be at a
higher risk for tooth decay because food is more easily trapped and packed in the teeth.
Patients with cerebral palsy are also more prone to having malocclusion or a misaligned
bite.
These patients also have a higher risk of caries, gingivitis, and periodontal
disease. This increased risk is due to uncontrolled biofilm, little to no motor function,
mouth breathing, GERD, medication side effects and lack of proper dental care. Another
also difficult for them to perform oral care due to the limited or restricted function of
facial muscles of the patient. Phenytoin is a medication that some cerebral palsy
patients take to control seizures. This medication has been proven to cause gingival
overgrowth which can increase risk of periodontal disease because the areas affected
have become so much hard to clean at home due to excessive gingival tissue and
limited access with a toothbrush and floss, meaning plaque and bacteria become
patients with cerebral palsy. There are several factors to take into account when
preparing for a dental appointment with a cerebral palsy patient. Patients may
experience a difficulty opening their mouth or holding their mouth open. A bite block
may be useful during treatment. And since they have little control over their mouth,
operators should be cautious about placing fingers and other objects in the patient’s
mouth because patient’s uncontrolled movements may lead to them suddenly closing or
biting down on fingers or other objects. It wouldn’t be a bad idea to have bite block in
this instance as well to protect from injury to the patient and operator. It may also be
recommended that a care giver be present to hold the patients head, arms, or legs still
during the appointment. Gag reflex may also be an issue, so placing the patient in a
neutral position should minimize this. It is also important to not force patient into a
patients may need to be done standing up in order for the patient to remain comfortable.
During the oral hygiene instruction, it is important to show the patient and caretaker
what you are talking about as well as having the patient show you what they understood
from your teachings. Without this confirmation of understanding, it is very possible that
caretakers and patients are sent home with little understanding or misguided
understanding. This is an issue with normal healthy patients as well, which is why
Home care may also be difficult for them. These people are being subjected to
floss daily to prevent dental disease. However, I know that there are some patients who
feel like their independence is being stripped away if they ask someone for help, so for
the few patients who are able I would recommend an auxiliary aid to help them brush
their teeth. A larger handle added to the patient’s toothbrush would help them hold the
toothbrush and maintain a little bit more control. An electric toothbrush may also be
beneficial. The mechanical movements will do a majority of the work, all the patient has
to do it get the toothbrush into their mouth. When it comes to flossing, patients will most
definitely need assistance. Floss is too flimsy and tedious for patients to perform care
on their own. A caretaker may also find a water flosser to be beneficial for the patient
instead of floss but that isn’t always possible. Regardless of which method is chosen,
the patient’s dental hygienist should educate them about how to clean their mouth. Now
obviously the proper bass technique will not always be possible due to the spastic
muscle movements and limited access. The biggest thing that we want to convey to the
patient is the importance of brushing twice a day, brushing every tooth, and getting any
and all food out of the mouth. Caretakers should also be educated in proper brushing
and flossing because there is such a disconnect between the medical and dental needs
of patients, and sometimes dental needs get swept under the rug.
In conclusion, cerebral palsy takes an effect on the patients physical, oral, and
provide thorough oral education to the patient and to their caretaker, provide any aids or
materials that may be needed for efficient home care, and make sure to keep these
Kim, S. (2020). The history and origin of cerebral palsy. Cerebral Palsy Foundation:
Koerber, K. N., Reibel, Y. G., Drake, M., & Arnett, M.C. (2020). Successful
Mordini, L. (2018). Maintaining oral health in patients with special needs. Dimensions
Waldman, H. B., Perlman, P. P., & Perlman, S. P. (2011). Periodontal care for
patients with special needs. Dimensions of Dental Hygiene, 9(9), pg. 78-80, 83.
Wu, Y. W., Xing, G., Fuentes-Afflick, E., Danielson, B., Smith, L. H., & Gilbert, W. M.