Oral Health, Dental Care and Aspiration History of Tube-Fed Children

Aim: The study aims were to determine incidence of chest infections (CI) or aspiration pneumonia (AP) for the tube-fed paediatric population known to Bradford Community Dental Service; understand medical characteristics of tube-fed patients in particular those vulnerable to CI/AP; determine the accuracy of dental-medical records taken by dentists; and understand oral health, oral hygiene regimens and dental care of tube-fed children with CI/AP history. Methods: Retrospective analysis of tube-fed patient records known to Bradford Community Dental Services. The information collated included: medical history, CI/AP episodes, oral health descriptors such as calculus, periodontal disease, caries, treatment received, and oral hygiene regimen. Results: 92 patients’ clinical records were analysed. 53.3% of this sample (49 patients) had a history of CI/AP between 2018-2020. No patients had complete or accurate medical histories in the dental record when compared to the medical records. The following co-morbidities made tube-fed children more vulnerable to CI/AP: being nil by mouth (NBM), having an unsafe swallow, using saliva reducing medication, using prophylactic antibiotics, using medication associated with a risk of gingival hypertrophy, having a history of dental general anaesthetic (GA). Oral health of tube-fed children with CI/AP was varied; calculus presence was high (65.3% of patients), and caries level was low (12.2%). Oral hygiene levels were variable. Tube-fed children with CI/AP who had unsafe swallow or were NBM had more calculus present, less caries, and were less likely to have had a dental GA, compared to those with a safe swallow or orally fed. Tube-fed children with CI/AP had greater experience of dental GA compared to those without CI/AP. Conclusions: Tube-fed children have complex medical needs with varying dental needs. Further research is required to understand what dental treatment is in their best interests.