Li-Wei Ou-Yang, Ya-Ting Chang, Hsin-Mao Hsu, Shih-Hao Chang, Chia-Ling Wu, Hui-Ju Tsai, Yu-Tung Huang, Tsung-Chieh Yao
This 11-year nationwide cohort study provides real-world evidence that routine dental scaling is associated with a substantially reduced risk of pneumonia and mortality in individuals with moderate-to-severe cerebral palsy. These findings highlight the importance of oral healthcare in preventing severe health outcomes in this vulnerable population.
BACKGROUND/PURPOSE: Pulmonary infection is a major cause of hospitalization and death in individuals with cerebral palsy. The impact of routine dental scaling, a standard procedure for removing oral biofilm, on the risk of pneumonia and mortality in individuals with cerebral palsy is unknown. This study aimed to investigate the association between routine dental scaling and the risk of pneumonia and mortality in individuals with moderate-to-severe cerebral palsy.
MATERIALS AND METHODS: This nationwide, population-based cohort study used data derived from Taiwan's National Health Insurance Research Database between 2009 and 2019. 12,853 individuals with moderate-to-severe cerebral palsy were identified. Individuals who received routine dental scaling for at least three consecutive years were compared to those without dental scaling. Propensity-score matching was applied to balance baseline characteristics. Multivariable Cox proportional hazards models and Fine-Gray competing-risks survival analyses were employed to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of pneumonia, pneumonia-related mortality, and all-cause mortality during 5-year follow-up period.
RESULTS: Among 2,440 matched pairs, routine dental scaling was significantly associated with reduced risks of pneumonia (HR: 0.41, 95 % CI: 0.28-0.58), pneumonia-related mortality (HR: 0.23, 95 % CI: 0.13-0.41), and all-cause mortality (HR: 0.24, 95 % CI: 0.19-0.32). These findings remained consistent across various subgroup and sensitivity analyses.
CONCLUSION: This 11-year nationwide cohort study provides real-world evidence that routine dental scaling is associated with a substantially reduced risk of pneumonia and mortality in individuals with moderate-to-severe cerebral palsy. These findings highlight the importance of oral healthcare in preventing severe health outcomes in this vulnerable population.