Pneumonia: Viral, bacterial and aspiration pneumonias are more common in children with CP than in other children. Oral-motor problems and GERD predispose to aspiration, while absent or impaired gag reflexes and cough prevent other children from effectively clearing their airways. Nurses working with this population can teach parents to seek medical attention right away for significant respiratory infections. Some children with CP have tracheostomy tubes, while others use ventilators. By periodically assessing the caregivers' skills in tracheostomy suctioning and ventilator care, nurses may be able to identify areas of risk.

Dental problems: Oral-motor problems combined with muscle spasticity of the arms and hands often make oral hygiene a significant challenge for the patient and caregivers. Nurses working with CP patients and caregivers need to be extremely diligent in teaching and reinforcing good oral hygiene techniques.

Several factors are important to the dental health of cerebral palsy patients:

• Facial, oral and neck muscle dystonias can cause malocclusion which may exaccerbate dysphagia, aspiration and abnormal enamel wear, etc.
• Children with CP have significantly higher incidence of decayed, missing and filled surfaces. A study by Rodrigues dos Santos MT found that permanent teeth showed by more plaque, malocclusion, bruxism, residual food and mouth breathing in the CP study group.
• Children with CP are likely to have enamel defects that predispose them to cavities. A study by Keinan demonstrated that significantly less prenatal enamel was produce in CP and Down syndrome patients. The enamel that was produced was less mineralized than in the control population. They suggest that analysis of exfoliated deciduous teeth may help evaluate the onset and the extent of inutero insult and its effect on later development.
• Drug induced gingival overgrowth results from an increase in the connective tissue extracellular matrix. Phenytoin, used to treat seizures common in the CP population, is known to exaggerate the degree of overgrowth. Functional difficulties, disfigurement, increased caries, and delayed eruption of permanent teeth are the main complications of drug-induced gingival overgrowth.

Muscle spasticity: Depending on the degree of muscle spasticity and the part(s) of the body involved, health care providers may offer various medical and/or surgical treatments. Benzodiazepines, such as diazepam, may be used for body-wide muscle relaxation. Baclofen, which blocks impulses from the spinal cord to the muscles, can be delivered either orally or by an implanted pump. Dantrolene, a drug that interferes with muscle contractions, is also used to relieve spasticity and afford more control of the voluntary muscles. Surgeons may lengthen too-short muscles and tendons to release a contracture and enhance joint use. In some cases, a child with CP may need a selective dorsal root rhizotomy, which reduces spasticity in the legs by reducing the nerve stimulation to the leg muscles. Nurses caring for children with medical or surgical treatments will tailor their interventions to meet the specific needs of the child, taking into account the nature of the physician's intervention.