ORO-FACIAL CONDITION IN 18 CHILDREN, 4 - 18 YEARS OLD, WITH RESPIRATION SUPPORT AND TRACHEOSTOMY

Leksell Eva, Selldn Hans

Department of Pedodontics, Eastman Institute, Stockholm, Sweden. LIVA, Astrid Lindgren Children's Hospital, Stockholm, Sweden. 

The study was conducted to investigate the oro-facial conditions in children given respiratory support after tracheostomy for more than 3 years. The children were suffering from neuromuscular diseases, depressed lung function or anatomical airway obstruction. 

Material and method: 18 children aged 4 - 18 years, living at home but treated and supervised from a specialized unit at Astrid Lindgren Children's hospital in Stockholm. 14 children were also tubefeeded. Oral examination was performed when the children had their regular oral care or in connection to laryngoscope examination. 

Results: Teeth and oral mucous membranes were in many children dry because of an open bite, inadequate saliva circulation and oral motor deficiencies. Gingivitis with established sub- and supragingival plaque was found in 14 children, gingival hyperplasia and calculus in 11. The non-tube fed children had caries. Traumatic injuries after laryngoscope examination affected 7 children. Additionally 13 had malocclusions, mainly caused by oral functional deficiencies. Oral sensitivity aberrations were seen in the majority of the children. The gag-reflex was easily induced. 

Conclusion: This investigation highlights the importance of having an appropriate treatment plan giving each child the best oral comfort, to prevent infectious challenge and to minimize oro-facial problems in the future. The plan has to be carefully adjusted to the child's medical protocol and to the family situation.

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