Assessment of Salivary Total Antioxidant Levels and Oral Health Status in Children with Cerebral Palsy

Oxidative stress plays a pivotal role in the pathogenesis of neurological disorders. Saliva may constitute a first line of defence, against free radical-modified oxidative stress. The objective of the present study was to evaluate Total Antioxidant Capacity(TAC), levels of Nitric Oxide(NO), and Sialic Acid (SA) in saliva of cerebral palsied children. Study design: Thirty four non-institutionalized children in the age group of 7-12 years having cerebral palsy formed the study group. The control group consisted of thirty three normal, healthy children. The W.H.O. criteria was used for diagnosis and recording of dental caries. Oral hygiene status was assessed using the Simplified Oral Hygiene Index OHI-S. Estimation of Total Antioxidant Capacity, levels of Nitric Oxide and Sialic Acid in saliva was done. Data obtained was subjected to statistical analysis. Results: Children with CP had higher deft scores than that of normal children. Oral hygiene of children with CP was significantly poorer than that of normal children. Total Antioxidant Capacity of saliva was significantly higher in normal children than cerebral palsied children. Levels of Sialic Acid in saliva were significantly higher in cerebral palsy children. Conclusions: In children with CP, TAC of saliva showed an inverse relation with dental caries.

cerebral palsy, TAC, SA, NO, dental caries

1. Nallegowda M, Mathur V, Singh U, Prakash H, Khanna M, Sachdev G et al. Oral health status in Indian children with cerebral palsy – A pilot study. IJPMR April;16(1):1-4. 2005.

2. Swallow JN. Dental disease in cerebral palsied children. Dev Med Child Neurol;10(2):180-9. 1968.

3. Nielsen L.Caries among children with cerebral palsy: Relation to CP- diagnosis, mental and motor handicap. ASDC J Dent Child;57(4):267-73. 1990.

4. Pope JE, Curzon ME. The dental status of the cerebral palsied children. Pediatr Dent:13(3):156-62. 1991.

5. Fishman S, Young WO, Haley JB, Sword C. The status of oral health in cerebral palsy children and their siblings. J Dent Child;34(4):219-27. 1967.

6. Rodrigues dos Santos MT, Masiero D, Novo NF, Simionato MR. Oral Conditions in children with cerebral palsy.J Dent Child;70(1):40-6. 2003.

7. Canakci CF, Cicek Y, Yildirim A, Sezer U, Canakci V. Increased levels of 8-Hydroyxydeoxyguanosine and malondialedehyde and its relationship with antioxidant enzymes in saliva of periodontitis patients. Eur J Dent; 3 (2):100-6.2009.

8. Greabu M, Battino M, Mohora M, Totan A, Spinu T, Totan C et al. Could constitute saliva the first line of defence against oxidative stress? Rom J Intern Med.;45(2):209-13. 2007.

9. Rai B Total salivary gluthathione levels: Periodontitis in smoker and non-smoker. Adv. in Med.Dent. Sci; 2(27):47-49. 2008.

10. Dodwad R, Betigeri AV, Preeti BP. Estimation of total antioxidant capacity levels in saliva of caries-free and caries-active children. Contemp Clin Dent.;2(1):17-20. 2011.

11. John J. The next best diagnostic tool. J of Biochem.:5(2):23-25. 2006.

12. Tulunoglu.O, Demirtas.S, Tulunoglu I. Total antioxidant levels of saliva in children related to caries, age and gender. Int J Paediatr Dent. ; 16(3):186- 91. 2006.

13. Aycicek A, Iscan A. Oxidative and antioxidative capacity in children with cerebral palsy. Brain ;31;69(6):666-8. 2006 .

14. WHO: Oral Health Survey – Basic methods. Geneva: 4th edition,1997.

15. Darby ML, Walsh MM. Dental Hygiene Theory and Practicr.1st edition. Philadelphia: WB Saunders, 1995:368.

16. Miglani DC, Beal JF, James PM, Behari SA. The assessment of dental cleanliness status of the primary dentition using a modification of the simplified oral hygiene index. (OHIS-M). J Indian Dent Assoc; 45(12): 385-8. 1973.

17. Miricescu D, Greabu M, Totan A, Didilescu A, Radulescu R. The antioxidant potential of saliva: Clinical significance in oral diseases. Therapeutics, Pharmacology and Clinical Toxicology;(2):139-143. 2011.

18. McDonald RE, Avery DR, Dean JA. Dentistry for the child and adolescents. 8TH edition. St Louis Mosby,2004.

19. Subramaniam P, Babu KL, Rodriguez A.Relation of salivary risk factors in dental caries in children with cerebral palsy. J Clin Pediatr Dent;34(4):355- 60. 2010.

20. Edgar WM, O’Mullane DM. Saliva and oral health.2nd edition. British Dental Journal.1996.

21. Hegde AM, Rai K, Padmanabhan V. Total antioxidant capacity of saliva and its relation with early childhood caries and rampant caries. J Clin Pediatr Dent.;33(3):231-4. 2009.

22. Prieto P, Pineda M, Aguilar M.Spectrophotometric quantitation of antioxidant capacity through the formation of a phosphomolybdenum complex: specific application to the determination of vitamin E. Anal Biochem. 1;269(2):337-41. 1999.

23. Smarason AK, Allman KG, Young D and Redman CW. Elevated levels of serum nitrate, a stable endproduct of nitric oxide in women with preeclampsia. Br J Obstet Gynaecol;104(5):538-43. 1997.

24. Winzler RJ, Devor AW, Mehl JW, Smyth IM. Studies on the mucoproteins of human plasma determination and isolation. J Clin Invest;27(5):609-616. 1948.

25. Morales Hurtado CC, Yadira Córdova M.Cerebral palsy: its effects on eruption of the first permanent molar and health-illness condition. Acta Odontol Venez.;25(1):13-33. 1987.

26. Brown JP, Schodel DR. A review of controlled surveys of dental disease in handicapped persons. ASDC J Dent Child.;43(5):313-20. 1976.

27. Molina I, Vinas L, Garcia-Godoy FM.Clinical eruption of permanent teeth in children with mental handicaps in Santo Domingo. Acta Odontol Pediatr.;3(2):69-73. 1982.

28. Maclaurim E,Shaw L,Foster T. Dental study of handicapped children attending special schools in Birmingham. Part I. Dental caries experience of children living in fluoridated area. Community Dent Health;2(4):249-57. 1985.

29. Kenneth E. Wessels. Dentistry and the handicapped patient.The University of Michigan. 1979: Vol 5.

30. Dougherty NJ.A review of cerebral palsy for the oral health professional. Dent Clin North Am.;53(2):329-38. 2009.

31. Selwitz RH, Nowjack-Raymer RE, Kingman A, Driscoll WS. Prevalence of dental caries and dental fluorosis in areas with optimal and above-optimal water fluoride concentrations: a 10-year follow-up survey.J Public Health Dent.;55(2):85-93. 1995.

32. Bardow A, Nyvad B, Nauntofte B.Relationships between medication intake, complaints of dry mouth, salivary flow rate and composition, and the rate of tooth demineralization in situ. Arch Oral Biol.;46(5):413-23. 2001.

33. Malamud D, Abrams WR, Bau H, Wang J, Chen Z, Corstjens P et al. Oral-based techniques for the diagnosis of infectious diseases.J Calif Dent Assoc. 34(4):297-301. 2006.

34. Pereslegina IA.The activity of antioxidant enzymes in the saliva of normal children. Lab Delo.;(11):20-3. 1989.

35. Uberos J, Alarcón JA, Peñalver MA, Molina-Carballo A, Ruiz M, González E et al. Influence of the antioxidant content of saliva on dental caries in an at-risk community.Br Dent J; 26;205(2) 2008.

36. Tranquilli AL, Bezzeccheri V, Scagnoli C, Mazzanti L, Garzetti GG. Amniotic levels of vascular endothelial growth factor and nitric oxide at the second trimester in Down’s syndromes. J. Mater. Fetal. Neonatal. Med; 13(1): 28-31.2003.

37. de Soet JJ, Nyvad B, Kilan M. Strain- related acid production by oral strep - tococci. Caries Res;34(4):486-90. 2000.

38. Mobarak EH, Abdallah DM. Saliva nitric oxide levels in relation to caries experience and oral hygiene.J Advanced Res; (2): 357–62. 2011.