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Morgan J, Zavras AT. Oral health care for individuals with intellectual and developmental disabilities: A statewide model. SPECIAL CARE IN DENTISTRY 2024. [PMID: 39075774 DOI: 10.1111/scd.13046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND AND AIM Effective strategies and practices can assist in forming future initiatives and policies to improve oral health for individuals with intellectual and developmental disabilities (IDD). This manuscript aims to describe the Tufts Dental Facilities (TDF), a university-state collaboration providing sustained statewide access to comprehensive oral health care for individuals with IDD. PROGRAM DESCRIPTION The TDF program was established in 1976 as the result of a class action lawsuit to improve medical and dental care for individuals with IDD residing at state institutions in Massachusetts. TDF, A partnership, between Tufts University School of Dental Medicine (TUSDM) and the Commonwealth of Massachusetts, is a network of seven dental clinics strategically positioned across the state. These clinics are specifically designed to meet the oral health needs of individuals with IDD. TUSDM's oral health providers with expertise in special care dentistry deliver comprehensive oral health care for over 6500 individuals with IDD, incorporating supportive care services and access to general anesthesia. Additionally, the program provides training in special care dentistry for dental residents and pre-doctoral dental students. CONCLUSIONS Leveraging state and university resources, TDF provides a model of a sustainable, long-term system for statewide access to oral health care for individuals with IDD.
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Affiliation(s)
- John Morgan
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Athanasios Thanos Zavras
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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İslamoğlu AH, Berkel G, Yildirim HS, Aktaç Ş, Bayram F, Sabuncular G, Güneş FE. Chewing difficulties, oral health, and nutritional status in adults with intellectual disabilities: A cross-sectional study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13225. [PMID: 38504582 DOI: 10.1111/jar.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/11/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Chewing difficulty, poor oral health, inadequate and imbalanced nutrition are serious health problems in individuals with intellectual disabilities. The participants' chewing abilities, oral health and nutritional status were analysed in this study. METHODS Forty-five adult participants with intellectual disabilities were included. Anthropometric measurements, oral health assessments, chewing ability evaluations and dietary intake analyses were conducted. RESULTS A 56.8% of the participants were classified as overweight or obese. Teeth grinding was reported in 33.3% of the participants, while 40.0% experienced drooling. All participants with Down syndrome and 58.6% of the participants with developmental delay had chewing difficulties. Inadequate nutrient intake was observed and the fibre, vitamins B1, B3, B9, sodium, phosphorus and iron intakes were significantly lower than reference values in those with chewing difficulty (p < .05). CONCLUSIONS Chewing difficulties were associated with lower intake of certain nutrients, highlighting the importance of addressing oral health and dietary counselling in this population.
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Affiliation(s)
- Ayşe Hümeyra İslamoğlu
- Department of Nutrition and Dietetics, Marmara University, Faculty of Health Sciences, İstanbul, Türkiye
| | - Gülcan Berkel
- Department of Oral and Maxillofacial Surgery, Marmara University, Faculty of Dentistry, Clinical Sciences, İstanbul, Türkiye
| | - Hatice Selin Yildirim
- Department of Periodontics, Marmara University, Faculty of Dentistry, Clinical Sciences, İstanbul, Türkiye
| | - Şule Aktaç
- Department of Nutrition and Dietetics, Marmara University, Faculty of Health Sciences, İstanbul, Türkiye
| | - Ferit Bayram
- Department of Oral and Maxillofacial Surgery, Marmara University, Faculty of Dentistry, Clinical Sciences, İstanbul, Türkiye
| | - Güleren Sabuncular
- Department of Nutrition and Dietetics, Marmara University, Faculty of Health Sciences, İstanbul, Türkiye
| | - Fatma Esra Güneş
- Department of Nutrition and Dietetics, İstanbul Medeniyet University, Faculty of Health Sciences, İstanbul, Türkiye
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Khawer MS, Da Silva K. The oral health-related quality of life for individuals with fetal alcohol spectrum disorder - a cross-sectional study. BMC Oral Health 2023; 23:822. [PMID: 37899489 PMCID: PMC10613354 DOI: 10.1186/s12903-023-03577-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/25/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND The oral health status of an individual can dramatically influence quality of life. Most individuals in Canada report having good oral health, however, this is not true for individuals with developmental disabilities such as fetal alcohol spectrum disorder (FASD). The purpose of this study is to compare the oral health-related quality of life (OHRQoL) of individuals with FASD and the general population in Saskatoon, Saskatchewan. Additionally, it aims to suggest ways to improve the oral health status and OHRQoL of these individuals. METHODS For this cross-sectional study, the Oral Health Impact Profile-14 (OHIP-14) survey was used to assess the impact that oral health related problems can have on an individual's quality life. This study used a cross-sectional cohort study design with a survey methodology. The sample population compromised of 154 individuals with FASD along with a separate control group of 154 otherwise healthy adults. RESULTS The results of the study showed that most of the individuals in the FASD group experienced pain in the past month. In both groups, cost was most frequently cited as a barrier to accessing care. The majority of individuals in the control group experienced a low impact across all OHIP-14 domains except for physical disabilities. However, in the FASD group, most individuals experienced higher impact scores in some of the categories including functional limitation, psychological discomfort, psychological disability and handicap. CONCLUSION The findings clearly demonstrate that there is a discernible effect on an individual's quality of life if they have poor oral health. In conclusion, further research is required to determine the most effective methods to improve the OHRQoL of individuals with disabilities.
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Affiliation(s)
- Mohammad Saad Khawer
- College of Dentistry, University of Saskatchewan, 123-105 Wiggins Road, Saskatoon, SK, S7N5E4, Canada
| | - Keith Da Silva
- College of Dentistry, University of Saskatchewan, 123-105 Wiggins Road, Saskatoon, SK, S7N5E4, Canada.
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KASIMOĞLU Y, AKAY C, ÇAYNAK Ö, AYTEPE Z, KORUYUCU M. Özel Bakım Gereksinimi Olan Bireylerde Ağız-Diş Bulgularının Değerlendirilmesi. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.678638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ward LM, Cooper SA, Hughes-McCormack L, Macpherson L, Kinnear D. Oral health of adults with intellectual disabilities: a systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1359-1378. [PMID: 31119825 DOI: 10.1111/jir.12632] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND There have been several past reports that adults with intellectual disabilities experience poor oral health (tooth loss, periodontal health and untreated dental caries). Loss of a functional dentition has serious consequences, including problems with chewing, swallowing, nutrition, speech, temporomandibular joint osteoarthritis and pain and systemic health conditions. Poor oral health is largely preventable through proactive oral care support. In recent years, social care provision for adults has changed, with deinstitutionalisation and home-based personalised care now being the typical provision in high income countries. Hence, oral health inequalities might be reducing. However, there is limited recent evidence-synthesis on the topic. We aimed to address this. METHOD PROSPERO registration number: CRD42018089880. We conducted a preferred reporting items for systematic reviews and meta-analyses systematic review of publications since 2008. Four databases were searched with a clear search strategy, strict inclusion criteria for selection of papers, double scoring (two raters), systematic data extraction and quality appraisal of included papers. RESULTS A total of 33/3958 retrieved articles were included, of which 14 were drawn from dental service users and 10 from Special Olympic athletes, therefore not necessarily being representative of the wider population with intellectual disabilities. Despite this limitation, adults with intellectual disabilities were still shown to experience poor oral health. High levels of poor oral hygiene and gingivitis were found, with many also affected by periodontitis and untreated dental decay. There is clear unmet need relating to both periodontal (gum) and tooth health, leading to tooth loss. CONCLUSIONS Despite reports in the past of poor oral health amongst adults with intellectual disabilities, and despite it being preventable, there remains a high burden of poor oral health. This highlights the need to raise awareness, and for polices on effective daily oral care, and appropriate service provision. The importance of oral health and its possible negative sequelae needs to be elevated amongst carers and professionals.
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Affiliation(s)
- L M Ward
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - S A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - L Hughes-McCormack
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - L Macpherson
- School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital and University of Glasgow Dental School, Glasgow, UK
| | - D Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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Makkar A, Indushekar KR, Saraf BG, Sardana D, Sheoran N. A cross sectional study to evaluate the oral health status of children with intellectual disabilities in the National Capital Region of India (Delhi-NCR). JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:31-39. [PMID: 30338591 DOI: 10.1111/jir.12553] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 09/06/2018] [Accepted: 09/23/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Children with intellectual disabilities (ID) have usually been reported to have poorer levels of oral hygiene and higher prevalence of dental caries than their compeers. The present study was conducted to assess the status of dental caries and oral hygiene in different categories of institutionalised children with ID (syndromic and non-syndromic) registered in various special schools of Delhi (National Capital Region, India). METHODS The present cross sectional study was conducted on 269 children [52 with cerebral palsy (CP), 35 with Down syndrome (DS), 30 with autism and 152 with non-syndromic intellectual disability] attending nine special schools who were examined for dental caries [Decayed, Missing and Filled Teeth index for permanent teeth (DMFT); decayed, missing/indicated for extraction, filled index for primary teeth (dmft) and prevalence of caries] and oral hygiene status [Oral Hygiene Index-simplified (OHI-S)]. The levels of disability were classified according to Stanford Binet scale as severe (IQ ≤ 35), moderate (IQ = 36-51) and mild (IQ = 52-67). Statistical analysis was performed using one way analysis of variance and post hoc test to compare the levels between groups at a significance level of P < 0.05. RESULTS Mean DMFT, dmft and OHI-S indices scores for all the children irrespective of the category and the level of ID were 2.12 ± 1.95, 0.97 ± 1.60 and 2.05 ± 1.07, respectively. As the level of ID increased among these children, the mean DMFT index and OHI-S index increased with no significant effect on dmft. However, children with severe ID had higher OHI-S and DMFT scores than children with mild or moderate ID. The dental caries prevalence was 86.53%, 68.57%, 76% and 86.18% in children with CP, DS, autism and non-syndromic intellectual disability, respectively. CONCLUSIONS The level of caries in permanent teeth and oral hygiene deteriorated with the increasing severity of ID as indicated by DMFT and OHI-S scores (severe > mild, moderate). However, the level of caries (dmft) was not affected by the level of ID in primary dentition. The prevalence of dental caries was highest among children with CP and least among children with DS.
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Affiliation(s)
- A Makkar
- Department of Paediatric Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - K R Indushekar
- Department of Paediatric Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - B G Saraf
- Department of Paediatric Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - D Sardana
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong, S.A.R
| | - N Sheoran
- Department of Paediatric Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
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Singhal S, McLaren L, Quinonez C. Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014. Canadian Journal of Public Health 2017; 108:e246-e250. [PMID: 31583607 DOI: 10.17269/cjph.108.5950] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/18/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In Canada, non-traumatic dental conditions (NTDCs) presenting in emergency departments (EDs) are dealt with by non-dental professionals who are generally not equipped to deal with such emergencies, resulting in an inefficient usage of heath care resources. This study aimed to assess the burden of ED visits for NTDCs in Ontario by observing trends from 2006 to 2014. METHODS Aggregate data for Ontario were obtained from the Canadian Institute for Health Information's National Ambulatory Care Reporting System. Data were examined for the whole of Ontario and stratified by 14 Local Health Integration Networks. Descriptive analysis was conducted for both number of people and number of visits, stratified by sex and age groups (0-5, 6-18, 19-64, and 65+ years). Numbers were also examined by neighbourhood stratifications, including urban/rural, income quintile and immigrant tercile. RESULTS Over the study period, an upward trend of visiting EDs for NTDCs was observed. Approximately 403 628 people in Ontario made 482 565 visits over the period of nine years. On average, 341 per 100 000 people, per year, visited. Young children, people living in neighbourhoods with lower income and higher immigrant concentration, and people living in the rural regions, visited EDs more for NTDCs during 2006-2014. CONCLUSION The upward and inequitable trends of utilization of EDs for NTDCs reinforce recognition of the important need for both universal and targeted approaches for primary prevention of dental conditions. To enhance equitable access to dental care, policy advocacy is required for publicly funding essential and emergency dental services for all.
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Affiliation(s)
- Sonica Singhal
- Dental Public Health, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada. .,Health Promotion, Chronic Disease and Injury Prevention Department, Public Health Ontario, Toronto, ON, Canada.
| | - Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Carlos Quinonez
- Dental Public Health, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada
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Drążewski D, Grzymisławska M, Korybalska K, Czepulis N, Grzymisławski M, Witowski J, Surdacka A. Oral Health Status of Patients with Lysosomal Storage Diseases in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030281. [PMID: 28282939 PMCID: PMC5369117 DOI: 10.3390/ijerph14030281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/20/2017] [Accepted: 03/02/2017] [Indexed: 01/20/2023]
Abstract
Patients with lysosomal storage diseases (LSDs) suffer from physical and mental disabilities, which together with poor access to professional care may lead to impaired oral health. This cross-sectional case-control study characterized the status of oral health in patients with LSDs in Poland. Thirty-six children and young adults with various forms of LSDs were examined. The data were compared with those from age- and sex-matched healthy controls. Exemplary cases were presented to highlight typical problems in oral care associated with LSDs. When possible, saliva was collected and analyzed for total protein, inflammatory mediators, and antioxidant status. Generally, patients with LSDs had significantly higher prevalence of caries, inferior gingival status, and inadequate oral hygiene. The severity of oral health impairment in mucopolysaccaridoses, the most common LSD in Poland, was similar to that seen in patients with mannosidoses or Pompe disease. Saliva could be collected only from few less handicapped patients. In MPS, it did not appear to differ significantly from the controls, but in patients with Pompe disease it contained lower concentrations of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1), but higher levels of tumor necrosis factor receptors 1 and 2 (TNF-R1, TNF-R2) and myeloperoxidase (MPO). In conclusion, Polish patients with LSDs have an inadequate level of oral hygiene and substantially deteriorated oral health.
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Affiliation(s)
- Damian Drążewski
- Department of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
| | | | - Katarzyna Korybalska
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
| | - Marian Grzymisławski
- Department of Metabolic Disease, Nutrition and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
| | - Anna Surdacka
- Department of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
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Minihan PM, Morgan JP, Park A, Yantsides KE, Nobles CJ, Finkelman MD, Stark PC, Must A. At-home oral care for adults with developmental disabilities: a survey of caregivers. J Am Dent Assoc 2014; 145:1018-25. [PMID: 25270700 PMCID: PMC4527551 DOI: 10.14219/jada.2014.64] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Little is known about effective at-home oral care methods for people with developmental disabilities (DDs) who are unable to perform personal preventive practices themselves and rely on caregivers for assistance. METHODS A convenience sample of 808 caregivers (84.5 percent paid, 15.5 percent family members) who accompanied adults with DDs (20 years or older) to appointments at a specialized statewide dental care system completed computer-assisted personal interview surveys. The authors used these data to investigate caregivers' at-home oral care experiences and to explore differences between caregivers who were paid and those who were family members. RESULTS Caregivers reported that a high proportion (85 percent) of dentate adults with DDs received assistance with tooth cleaning. They also reported a high prevalence of dental problems, and low adherence to brushing (79 percent) and flossing (22 percent) recommendations. More caregivers reported that they felt confident assisting with brushing than with flossing (85 percent versus 54 percent). Family members and paid caregivers differed with respect to confidence and training. CONCLUSIONS At-home oral care, particularly flossing, presents substantial challenges for adults with DDs. Solutions must be tailored to address the different experiences and distinct needs of the family members and paid caregivers who assist these adults. PRACTICAL IMPLICATIONS Caregivers play an important role in providing at-home oral care, and they must be included in efforts to improve oral health outcomes for people with DDs.
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Affiliation(s)
- Paula M Minihan
- Dr. Minihan is an assistant professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, Mass. 02111, e-mail . Address correspondence to Dr. Minihan
| | - John P Morgan
- Dr. Morgan is an associate professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston
| | - Angel Park
- Ms. Park is a research analyst, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston
| | - Konstantina E Yantsides
- Ms. Yantsides was a research assistant, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, at the time this study was conducted. She now is a senior research coordinator with Tufts University School of Medicine
| | - Carrie J Nobles
- Ms. Nobles was a research assistant, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, at the time this study was conducted. She now is with the University of Massachusetts, Amherst
| | - Matthew D Finkelman
- Dr. Finkelman was an assistant professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, at the time this study was conducted. He now is with the Clinical and Translational Science Institute at Tufts Medical Center and Tufts University
| | - Paul C Stark
- Dr. Stark is a professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston
| | - Aviva Must
- Dr. Must is a professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston
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Finkelman MD, Stark PC, Tao W, Morgan JP. Relationship between duration of treatment and oral health in adults with intellectual and developmental disabilities. SPECIAL CARE IN DENTISTRY 2013; 34:171-5. [DOI: 10.1111/scd.12049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Matthew D. Finkelman
- Assistant Professor, Department of Public Health and Community Service; Tufts University School of Dental Medicine; Boston MA
| | - Paul C. Stark
- Professor, Department of Public Health and Community Service; Tufts University School of Dental Medicine; Boston MA
| | - Wen Tao
- Health Quality Data Analyst; Children's Hospital Boston; Boston MA
| | - John P. Morgan
- Associate Professor, Department of Public Health and Community Service; Tufts University School of Dental Medicine; Boston MA
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Abstract
Children with developmental disabilities often have unmet complex health care needs as well as significant physical and cognitive limitations. Children with more severe conditions and from low-income families are particularly at risk with high dental needs and poor access to care. In addition, children with developmental disabilities are living longer, requiring continued oral health care. This clinical report describes the effect that poor oral health has on children with developmental disabilities as well as the importance of partnerships between the pediatric medical and dental homes. Basic knowledge of the oral health risk factors affecting children with developmental disabilities is provided. Pediatricians may use the report to guide their incorporation of oral health assessments and education into their well-child examinations for children with developmental disabilities. This report has medical, legal, educational, and operational implications for practicing pediatricians.
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Perea-Pérez B, Labajo-González E, Bratos-Murillo M, Santiago-Sáez A, Albarrán-Juan E, Villa-Vigil A. The clinical safety of disabled patients: proposal for a methodology for analysis of health care risks and specific measures for improvement. Med Oral Patol Oral Cir Bucal 2013; 18:e251-6. [PMID: 23385500 PMCID: PMC3613877 DOI: 10.4317/medoral.18262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 08/08/2012] [Indexed: 01/22/2023] Open
Abstract
The clinical risks associated with health care have been a known factor since ancient times, and their prevention has constituted one of the foundations of health care. However, concern for the risks involved in health care treatments has risen very significantly in recent years, becoming a modern current of concern for clinical health care risks which is referred to by the name of "patient safety" in the scientific literature. Unfortunately, there are no studies on patient safety in dental practice or case studies of adverse events in this practice. In addition to the lack of studies on adverse events in regular dental practice, there are even fewer references to treatment for disabled patients. In this article, we provide a "proposal for analysis" of the clinical risks associated with treating disabled patients, which will make it possible to evaluate the health care risks associated with the treatment of patients who have a specific disability, at one determined moment and in one specific environment.
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The oral health status of 4,732 adults with intellectual and developmental disabilities. J Am Dent Assoc 2012; 143:838-46. [DOI: 10.14219/jada.archive.2012.0288] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Anders PL, Davis EL. Oral health of patients with intellectual disabilities: a systematic review. SPECIAL CARE IN DENTISTRY 2010; 30:110-7. [PMID: 20500706 DOI: 10.1111/j.1754-4505.2010.00136.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A systematic review of original studies was conducted to determine if differences in oral health exist between adults who have intellectual disabilities (ID) and the general population. Electronic searching identified 27 studies that met the inclusion criteria. These studies were assessed for strength of evidence. People with ID have poorer oral hygiene and higher prevalence and greater severity of periodontal disease. Caries rates in people with ID are the same as or lower than the general population. However, the rates of untreated caries are consistently higher in people with ID. Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. Evidence supports the need to develop strategies to increase patient acceptance for routine care, additional training for dentists to provide this care, and the development of more effective preventive strategies to minimize the need for this care.
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Affiliation(s)
- Patrick L Anders
- Department of Oral Diagnostic Sciences, State University of New York at Buffalo School of Dental Medicine Buffalo, New York, USA.
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