Association between motor proficiency and oral health in people with intellectual disabilities.

BACKGROUND: People with intellectual disabilities (IDs) may be at increased risk of developing periodontal diseases and dental caries due to poor oral hygiene. Our aim was to investigate motor proficiency factors associated with presence of visible plaque and gingival bleeding in people with IDs. We were particularly interested in the level of dependence, manual coordination and fine manual control of people with ID, as well as the level of exhaustion of the primary caregiver. METHODS: In this cross-sectional study, 299 people with ID were evaluated for oral hygiene using the simplified Visible Plaque Index and for gum inflammation using the Gingival Bleeding Index. The Bruininks-Oseretsky Motor Proficiency Test assessed motor proficiency through fine manual control (fine motor integration and fine motor precision) and manual coordination (manual dexterity and upper limb coordination). The level of dependence was assessed by the Katz dependency index, and the caregiver was tested for exhaustion using the fatigue severity scale. Prevalence ratios [and 95% confidence intervals (CI)] were calculated using crude and adjusted Poisson regression with robust variance. RESULTS: The exhaustion of the caregiver was associated positively to visible plaque [prevalence ratio (PR) = 1.36; 95% CI 1.06-1.65]. For gingival bleeding, people with IDs that had better fine motor integration (PR = 0.49; 95% CI 0.33-0.75) and precision (PR = 0.50; 95% CI 0.26-0.94), as well as manual dexterity (PR = 0.62, 95% CI 0.49-0.77), presented better results. CONCLUSION: Poor oral hygiene and gum inflammation were associated with motor proficiency of people with IDs and caregivers' exhaustion. Interventions to improve the oral health of people with IDs should take into account such conditions.

Association between oropharyngeal dysphagia, oral functionality, and oral sensorimotor alteration.

OBJECTIVE: To evaluate whether the oral functionality and the oral sensorimotor alterations are associated with oropharyngeal dysphagia in community-dwelling older persons and long-term care older residents. METHODS: An exploratory study with 265 independent older persons of the southern state of Brazil. The diagnosis of dysphagia, as well as the condition of the oral sensorimotor system, was assessed by a speech-language therapist and the oral health status by a dentist. Poisson Regression with robust variance was used to calculate the crude and adjusted Prevalence Ratios (PR) and their respective confidence intervals of 95%. RESULTS: The mean age was 73.5 (±8.9) years, women represented 59.2% of the sample. The frequency of dysphagia in the studied population was 45.3% (n = 120), being more frequent in the long-term care older residents (62.5%; n = 75) than in the community-dwelling older persons (37.5%; n = 45). Individuals with four or more oral sensorimotor alterations (PR = 2.01; 95% CI 1.27-3.18), as well as those who presented a non-functional oral status (PR = 1.61; 95% CI 1.02-2.54) presented a higher frequency of dysphagia. Subgroup analysis indicates the same trend of results, when stratified by community-dwelling older persons and long-term older residents. CONCLUSION: A non-functional oral health status and oral sensorimotor alterations are associated with a higher prevalence of oropharyngeal dysphagia.

Immunoregulatory abnormalities in children with thrombocytopenic purpura.

Twenty-eight children with idiopathic thrombocytopenia and 51 members of their immediate families were studied for immunologic function and expression of autoimmune phenomena and disease. Among patients with active ITP, 64% had defective immunoregulatory lymphocytes. The majority of patients (23/28) and family members had one or more immunologic abnormalities, including autoantibodies, other autoimmune disorders, and abnormalities in complement, immunoglobulins, or regulatory T lymphocytes. These data suggest that a genetic predisposition to autoimmunity is present in the majority of children with ITP.