Routine dental scaling and reduced risk of serious infections in individuals with moderate-to-severe cerebral palsy: A nationwide population-based cohort study

Authors

• Li-Wei Ou-Yang, Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
• Yu-Tung Huang, National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan
• Ya-Ting Chang, Division of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
• Hsin-Mao Hsu, Division of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
• Shih-Hao Chang, Graduate Institute of Dental and Craniofacial Science, Chang Gung University College of Medicine, Taoyuan, Taiwan
• Chia-Ling Wu, Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
• Tsung-Chieh Yao, Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, TaiwanFollow

Abstract

Background/ purpose: Individuals with moderate-to-severe cerebral palsy (CP) are highly susceptible to serious infections. Oral biofilms may serve as reservoirs for pathogenic microorganisms, yet the impact of professional oral healthcare on systemic infection risk in this population remains unclear. This study investigated the association between routine dental scaling and the risk of serious infections and infection-related mortality among individuals with moderate-to-severe CP.

Materials and methods: This nationwide, population-based cohort study used data from Taiwan’s National Health Insurance Research Database and National Death Registry (2009–2019). Individuals with moderate-to-severe CP were categorized into a routine dental scaling group (≥1 scaling annually for three consecutive years) and a non-scaling group. One-to-one propensity score matching was performed. The primary outcome was overall serious infection, defined as a composite of pneumonia, cellulitis or soft tissue infection, sepsis, acute gastroenteritis, and other major infections. Fine-Gray models were used to estimate infection risk accounting for competing mortality, and Cox proportional hazards models were applied for infection-related mortality over a 5-year follow up.

Results: After matching, 2,745 pairs were analyzed (median age, 21 years). Routine dental scaling was associated with a significantly lower risk of overall serious infection (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.26–0.41) and infection-related mortality (HR, 0.26; 95% CI, 0.18–0.39). Findings were consistent across subgroup and sensitivity analyses.

Conclusion: Routine dental scaling was associated with a significantly reduced risk of serious infections and infection-related mortality in individuals with moderate-to-severe CP, highlighting it’s potential role in systemic infection prevention.

Recommended Citation

Ou-Yang, Li-Wei; Huang, Yu-Tung; Chang, Ya-Ting; Hsu, Hsin-Mao; Chang, Shih-Hao; Wu, Chia-Ling; and Yao, Tsung-Chieh (2026) "Routine dental scaling and reduced risk of serious infections in individuals with moderate-to-severe cerebral palsy: A nationwide population-based cohort study," Journal of Dental Sciences: Vol. 21: Iss. 4, Article 28.
Available at: https://jds.ads.org.tw/journal/vol21/iss4/28

Publication Date

2026

Received Date

June 2 2026

Accepted Date

June 12 2026

Final Revision Date

June 12 2026