The influence of the structure of the masticatory system on the presence and severity of the gag reflex in children with cerebral palsy

Dysphagia, prevalent in 90% of children with neurological disorders, poses risks of medical complications and is associated with cognitive and psychosocial challenges. The absence of the sucking-swallowing reflex and variations in the gag reflex contribute to feeding difficulties. This study focuses on examining the impact of the gag reflex on the masticatory system structure in children with cerebral palsy, aiming to assess its significance. This observational study investigated the gag reflex and soft palate shape in 25 children with cerebral palsy (average age: 14 years). Inclusion criteria considered specific levels of the Eating and Drinking Ability Classification System (EDACS) and the Gross Motor Function Classification System (GMFCS). Exclusion criteria comprised hypotension, inflammation and tumors. The Castillo-Morales questionnaire assessed variables and statistical analysis (Spearman's rank correlation and non-parametric tests) utilizing PQStat v. 1.8.6.120 software. Findings did not reveal an association between the absence of the gag reflex and abnormal palate structure in children. Our results showed a correlation between higher tension of the buccinator muscles and mobility of the tongue on the structure of the palate. Children with neurological disorders, such as cerebral palsy, are a diverse group requiring specialized orthodontic treatment and close interdisciplinary collaboration.