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Philip P, Prasanna P, Vijaya Remi R, Samuel R, George WT, Joseph MSA, Lim M, Armstrong G, Grills N. Prevalence of dental caries among children and adolescents with intellectual disability in India: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13278. [PMID: 39072860 DOI: 10.1111/jar.13278] [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: 07/08/2022] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Children with intellectual and developmental disabilities are at a higher risk of developing dental caries. Few scoping reviews have been conducted in India to understand their issues. We aimed to summarise the distribution and risk factors of dental caries among children and adolescents with intellectual disabilities in India. METHODS A scoping review was conducted based on the Arksey O Malley framework. Quality assessment of studies, descriptive and thematic analyses were also conducted. RESULTS We charted, collated, and summarised from four databases. Thirty-one studies met the study criteria consisting of children and adolescents with intellectual disabilities. Median caries prevalence was 70%, decayed missing and fIlled permenant teeth (DMFT) was 2.4, decayed missing and filled decidous teeth (dmft) was 2.36, and DMFS was 3.7. Major determinants were the severity of disability, socioeconomic status and parents' education. Oral care and dental visits were inadequate. CONCLUSION Further exploration is required to improve access and reduce caries experience and prevalence among children with intellectual and developmental disabilities in India.
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Affiliation(s)
- Philcy Philip
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Praveen Prasanna
- Department of Pediatric and Preventive Dentistry, D.A.Pandu Memorial R.V Dental College, Bengaluru, India
| | - Ravi Vijaya Remi
- Department of Pediatric and Preventive Dentistry, D.A.Pandu Memorial R.V Dental College, Bengaluru, India
| | - Reena Samuel
- Community Health Department, Bangalore Baptist Hospital, Bengaluru, India
| | - Willy T George
- Community Health Department, Bangalore Baptist Hospital, Bengaluru, India
| | | | - Mathew Lim
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nathan Grills
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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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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Floríndez LI, Como DH, Law E, Tran CF, Johnson R, Polido JC, Cermak SA, Stein Duker LI. Oral care interventions for autistic individuals: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241260171. [PMID: 39056277 DOI: 10.1177/13623613241260171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
LAY ABSTRACT Oral care-related challenges are well documented in the autistic community; dental care remains one of the most prevalent unmet health needs among autistic individuals. This review examined interventions designed to improve oral health in autistic individuals from children and adult populations. Through a systematic process, 36 studies were identified. These studies focused on improving home-based oral care skills and routines and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated different types of techniques for facilitating oral care practice, including preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management. Using an evidence-based rubric, we reviewed the methodological quality of the studies and found that most were only "adequate" (n = 8) or "weak" (n = 23) in reporting their evidence. This review has two key findings: (1) there is support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits; and (2) distraction or sensory-reducing interventions may also improve experiences in the dental clinic. Only one study purposefully recruited autistic adults, and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for more studies investigating the impact of oral care-related interventions for autistic individuals of all ages and identifies a gap in interventions for autistic adults and those from minoritized populations.
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Nanji N, Nanji A, Chamut S, Chandel T. Advancing dental care access for patients with disabilities: A global scoping review of predoctoral training. J Dent Educ 2024; 88:957-973. [PMID: 38597196 DOI: 10.1002/jdd.13508] [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: 12/03/2023] [Revised: 02/08/2024] [Accepted: 02/23/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To examine predoctoral training programs that address the unique needs of patients with special healthcare needs (SHCN) and provide an overview of current global training initiatives, while exploring innovative approaches to enhance dental students' preparation in managing SHCN patients. METHODS A scoping review (SR) was conducted focusing on three key concepts: dental education, pre-doctoral training, and intellectual disability/developmental disability. The search encompassed five databases including Medline, Embase, Dentistry and Oral Sciences Source (EBSCO), Global Health (EBSCO), and WHO Global Index Medicus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EndNote and Covidence were utilized to prevent duplication and facilitate title/abstract screening. RESULTS After screening abstracts, a total of 2309 articles were initially identified with 28 articles meeting eligibility criteria for data extraction relevant to the research question. Two major categories characterized the key findings included in the review: 12 interventional studies and 16 perception-based studies. CONCLUSION This SR revealed that dental students are not adequately trained to treat special needs populations; consequentially, dental students lack confidence in providing high-quality care to this demographic. The absence of standardized training poses a global challenge, exacerbating care disparities. Addressing this issue is crucial to better prepare dental students and advance equitable access and quality care for underserved populations.
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Affiliation(s)
- Natasha Nanji
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Alisha Nanji
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Steffany Chamut
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Tejasvita Chandel
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Takeshita L, Srinivasan M. Survey on the attitudes and perceptions of Swiss dental practitioners and dental students toward treating patients with disabilities and sensory impairments. SPECIAL CARE IN DENTISTRY 2024; 44:1260-1272. [PMID: 38483203 DOI: 10.1111/scd.12988] [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: 08/14/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 07/18/2024]
Abstract
AIMS This study evaluated the attitudes and perceptions of private dental practitioners (PPs) and students on treating patients with disabilities and sensory impairments. METHODS AND RESULTS A multifaceted questionnaire was used to assess the participants' attitudes on providing care to persons with disabilities and sensory impairments [visual (VI) and hearing (HI)]. The survey evaluated different aspects of the participants' attitudes that included integrity, altruism, perceived barriers, and theory of planned behavior (TPB). One hundred twenty participants [students: n = 73, practitioners (PP): n = 47), with a mean-age of 27.7 ± 5.3 years, completed the survey (response rate: 100%). Fourth-year students scored better than the PP in integrity (p = .019). For altruism, the students scored better than PPs (vs. fourth-year: p = .009, vs. fifth-year: p = .031). There were no differences between the participant groups for the overall assessments of the TPB (p = .213), VI (p = .863), and HI (p = .261). CONCLUSION Dental practitioners and students revealed a positive attitude, with few barriers, towards treating individuals with disabilities/sensory impairments and considered the training in the field of special care dentistry as a necessary part of the dental education. Furthermore, a demand for an increase in the hands-on practical experience in treating individuals with disabilities/sensory impairments during the undergraduate study curriculum was identified.
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Affiliation(s)
- Lisa Takeshita
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Bhadauria US, Purohit B, Priya H. Access to dental care in individuals with disability: a systematic review. Evid Based Dent 2024; 25:111. [PMID: 38225370 DOI: 10.1038/s41432-024-00970-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE This systematic review was conducted to explore the factors influencing access to oral health services and to identify and examine the strategies to improve the access. MATERIALS AND METHODS PubMed, Scopus and Embase databases were searched. Studies except editorials reported in English regardless of the study design were included. Risk of Bias assessment was carried out using Agency for Healthcare Research and Quality, Newcastle Ottawa Scale and The Joanna Briggs Institute tool for cross-sectional, case-control and cohort and qualitative studies, respectively. RESULTS In total, 11,372 records were initially identified, eventually leading to 12 relevant publications to be included in the review. Individuals valued oral health but found it difficult to access oral health services. Dental care was mainly accessed during emergencies and participants felt apprehensive in visiting dentists. Caregiver's and dentist's perspective was also reported. CONCLUSION There is a need for provision of education, training and increasing awareness on dental hygiene and annual dental checkups to improve access.
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Affiliation(s)
- Upendra Singh Bhadauria
- Division of Public Health Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India
| | - Bharathi Purohit
- Division of Public Health Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India
| | - Harsh Priya
- Division of Public Health Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India.
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Tan SHX, Lee GKY, Goh CE, Tong HJ, Chuang JCP, Ang KY, Lim DGX, Gao X. Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore. Community Dent Oral Epidemiol 2024; 52:336-343. [PMID: 38644526 DOI: 10.1111/cdoe.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND/AIM(S) Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. METHODS Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. RESULTS Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. CONCLUSION Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Charlene Enhui Goh
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Huei Jinn Tong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | | | | | - David Guang Xu Lim
- Tzu Chi Singapore Free Clinic, Buddhist Compassion Relief Tzu Chi Foundation, Singapore, Singapore
- National Dental Centre Singapore, Singapore, Singapore
| | - Xiaoli Gao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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McGeown D, Mac Giolla Phadraig C, Van Harten M, Stapleton S, Nunn J. Dental extractions do not predict further use of dental general anesthesia in people with disabilities: A longitudinal analysis. SPECIAL CARE IN DENTISTRY 2024; 44:845-851. [PMID: 37737693 DOI: 10.1111/scd.12925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES This paper describes treatments completed under dental general anesthesia (DGA) for a cohort of adults with disabilities. This patient cohort was followed up a number of years later to determine outcomes and identify factors that predict further use of DGA. METHODS A retrospective patient record review and cross-sectional survey was carried out on a convenience sample of 64 patients who had previously received dental treatment under general anesthesia. Patient record review extracted data on patient demographics and treatment provided under DGA. Cross-sectional survey a number of years post-DGA collected data on oral care habits and current oral health based on a standardized clinical examination. Statistical analysis was carried out to identify predictors of repeat DGA. RESULTS Participants received extensive treatment under DGA including preventive care, restorations, extractions, and root canal treatment. At follow-up 89.1% of participants had gingival disease and 56.3% had active dental caries. The mean number of teeth present was 21.2 (SD 6.9, range 6-32). Only caries risk status was found to be a significant predictor (p = 0.03) with those with a high caries risk status 6.9 times (95%CI 1.2-39.3) more likely to receive a second DGA. CONCLUSIONS Dentists extract teeth for people with disabilities under DGA in the mistaken belief that this will avoid the need for further DGA. This study found that extraction of teeth does not prevent the need for repeated episodes of DGA. Therefore, dentists should stop extracting teeth for this reason. Rather, if dentists want to avoid further DGA, they should do the basics well: consistent, evidence-based caries risk assessment and risk reduction.
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Affiliation(s)
- Danielle McGeown
- Department of Child and Public Dental Health, School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland
| | - Caoimhin Mac Giolla Phadraig
- Department of Child and Public Dental Health, School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland
| | - Maria Van Harten
- Department of Child and Public Dental Health, School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland
| | - Siobhan Stapleton
- Department of Child and Public Dental Health, School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland
| | - June Nunn
- School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland
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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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Alzahrani AAH. Periodontal Health among Individuals with Intellectual Disabilities Living in a Saudi Institutional Rehabilitation Centre. Healthcare (Basel) 2024; 12:891. [PMID: 38727448 PMCID: PMC11083931 DOI: 10.3390/healthcare12090891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of this study was to explore periodontal health among intellectually disabled individuals living in an institutional rehabilitation centre in the Al-Baha Region of Saudi Arabia. A cross-sectional study was conducted from November 2023 to January 2024. Clinical oral examinations were carried out using the World Health Organization criteria for bleeding sites and the presence of periodontal pockets. Simplified oral hygiene and community periodontal indices were employed to evaluate participants' oral health. A total of 89 participants, comprising both males and females with intellectual disabilities, were included in this study. Gender, severity of intellectual disability, type of additional physical disability, tooth brushing habits and oral hygiene status were significantly associated with the presence of periodontal disease. Additionally, poor oral hygiene, not brushing teeth and periodontal pockets of 4-5 mm and 6 mm or more were significantly more prevalent among individuals with severe and moderate intellectual disabilities (p = 0.001, p = 0.001, p = 0.001 and p = 0.001, respectively). The prevalence of periodontal disease among the studied population was 54%. The odds of having periodontal disease were significantly higher in the severe intellectual disability group compared to the mild intellectual disability group (OR = 2.328, 95% CI = 1.430-3.631, p = 0.03). It was also found that intellectually disabled participants with additional physical disabilities suffered more from periodontal disease than those without additional physical disabilities (OR = 0.971, 95% CI = 0.235-4.023, p = 0.025). Overall, individuals with intellectual disabilities had a significant demand for periodontal care. This study highlighted the need for more organised preventive programmes for individuals with intellectual disabilities. Dentists should be vigilant about improving periodontal health, focus on preventive programmes and provide comprehensive dental care with an emphasis on periodic recall and monitoring.
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Affiliation(s)
- Abdullah Ali H Alzahrani
- Dental Health Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha 65731, Saudi Arabia
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Otero GR, Mundiña BR, García-Mato E, Aneiros IV, López LS, Iglesias JRG. Development and evaluation of a new website on oral health and Down syndrome. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38566329 DOI: 10.1111/scd.13000] [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: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
AIMS The objective of this study was to develop a new website in Spanish on oral health and dental care for use by the relatives/caregivers of individuals with Down syndrome, with the aim of incorporating the strengths and avoids the deficiencies of existing websites. METHODS A freely accessible website was developed with dental content, whose access criteria included the age of the individual undergoing the consultation and the area of interest (tongue or teeth disease, oral functionality, oral hygiene, and dental visits). The definitive version of the website was analyzed by five external examiners, applying the DISCERN criteria and the Questionnaire to Evaluate Health Web Sites According to European Criteria (QEEC). The website's traffic during the first year of activity was recorded. RESULTS The new website is known as "DentiDown", and its access domain is https://odontoloxia-accessible.org/dentidown/. On the home screen, the age group of interest to the user can be accessed. A dropdown menu then opens, listing the various options according to the area of interest. The oral hygiene section provides advice for improving toothbrushing efficacy through demonstration videos. With the DISCERN tool, an overall score of 4.75 ± 0.5 was achieved. With the QEEC, the external examiners' general opinion was highly favorable. The website received the seal of quality from the Accredited Medical Web (AMW). During the first year of activity, a total of 4536 visits from a total of 45 countries were recorded. CONCLUSION A new Spanish website has been developed on oral health for use by the relatives/caregivers of individuals with Down syndrome. The website has been favorably evaluated by external experts and, to date, is the only one with these characteristics with the AMW seal of quality.
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Affiliation(s)
- Gemma Rey Otero
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Berta Rivas Mundiña
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Eliane García-Mato
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Iván Varela Aneiros
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Lucía Sande López
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - José Ramón García Iglesias
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
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Schnabl D, Strohm MM, Schummer PE, Sigwart L, Kapferer-Seebacher I. Retrospective Evaluation of 20 Years of Outpatient Dental Services to Adults with Disabilities at the Dental Hospitals of the Medical University of Innsbruck, Austria. Healthcare (Basel) 2024; 12:503. [PMID: 38470614 PMCID: PMC10931228 DOI: 10.3390/healthcare12050503] [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: 01/08/2024] [Revised: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Disabled persons' chairside dentistry is challenging. We aimed for a retrospective breakdown of dental services delivered to disabled patients by dental students and to discuss feasibility of a chairside approach. Consecutive patients, who received scheduled dental treatment by dental students from 2002 to 2021, were included. Demographic data, medical diagnoses, number of treatment sessions, performed treatments, and treatment break-offs were collected and analyzed with descriptive statistics. In total, 224 individuals with various disabilities (mean age 36.4 ± 14.6 years) received dental services in 2282 sessions altogether (10.3 ± 11. sessions per patient). Professional tooth cleaning was the most frequently provided treatment (55.8% of sessions). A total of 654 teeth were restored with fillings, 97 teeth were extracted, 56 teeth had endodontic treatment, and 25 removable dentures were fitted. Treatment break-off due to incompliance and referral to dental general anesthesia occurred in 74 patients (33%). Chairside treatment of disabled persons by dental students is feasible in many cases. Our study may serve as an incentive for clinicians/researchers to report on treatment modalities and outcomes of chairside dentistry in patients with special oral health care needs, preferably by the use of prospective study designs, to contribute data and strategies in the fight for control of oral health inadequacies.
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Affiliation(s)
- Dagmar Schnabl
- University Hospital of Dental Prosthetics, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.M.S.)
| | - Matthias Michael Strohm
- University Hospital of Dental Prosthetics, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.M.S.)
- University Hospital of Conservative Dentistry and Periodontology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (L.S.); (I.K.-S.)
| | - Pit Eugene Schummer
- University Hospital of Dental Prosthetics, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.M.S.)
- University Hospital of Conservative Dentistry and Periodontology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (L.S.); (I.K.-S.)
| | - Lukas Sigwart
- University Hospital of Conservative Dentistry and Periodontology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (L.S.); (I.K.-S.)
| | - Ines Kapferer-Seebacher
- University Hospital of Conservative Dentistry and Periodontology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (L.S.); (I.K.-S.)
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13
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Biasotto M, Poropat A, Porrelli D, Ottaviani G, Rupel K, Preda MTB, Di Lenarda R, Gobbo M. Dental Treatment in Special Needs Patients and Uncooperative Young Children: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:91. [PMID: 38256352 PMCID: PMC10820169 DOI: 10.3390/medicina60010091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/24/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Special Needs Patients (SNPs) and young non-collaborative children are more predisposed to develop oral pathologies due to poor collaboration and scarce access to dental treatment. The aim of this retrospective study was to analyze a sample of SNPs who received dental treatments either under general anesthesia (GA) or deep sedation (DS) over a period of 6 years. The number and type of procedure were analyzed. Materials and Methods: In total, 131 patients were included and mostly (>90%) treated under GA. Patients were either uncooperative and phobic (Group 1) or affected by mental, behavioral, and neurological disorders (Group 2), diseases of the nervous system (Group 3), or developmental anomalies (Group 4). Results: Patients in Group 2 required more invasive dental treatments than those in the other groups. Therapies were mainly preventive and restorative, except in Groups 3 and 4, where extractions were more frequent. The type of dental treatment significantly varied according to age and systemic condition. Only 5.3% of the patients needed a second intervention, despite only 17.6% of patients respecting the scheduled follow-up. Conclusions: Treatment under GA is effective, but the poor adherence to follow-ups and the risk of reintervention should be contrasted by improving the perception by parents/guardians of the importance of oral hygiene and periodic visits.
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Affiliation(s)
- Matteo Biasotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy; (M.B.); (K.R.); (M.T.B.P.); (R.D.L.)
| | - Augusto Poropat
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy; (M.B.); (K.R.); (M.T.B.P.); (R.D.L.)
| | - Davide Porrelli
- Department of Life Sciences, University of Trieste, 34125 Trieste, Italy;
| | - Giulia Ottaviani
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy; (M.B.); (K.R.); (M.T.B.P.); (R.D.L.)
| | - Katia Rupel
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy; (M.B.); (K.R.); (M.T.B.P.); (R.D.L.)
| | - Magdalena Theodora Bogdan Preda
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy; (M.B.); (K.R.); (M.T.B.P.); (R.D.L.)
| | - Roberto Di Lenarda
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy; (M.B.); (K.R.); (M.T.B.P.); (R.D.L.)
| | - Margherita Gobbo
- Unit of Oral and Maxillo Facial Surgery, Ca’ Foncello Hospital, 31100 Treviso, Italy
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14
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Bracconi M, Michault A, Rey-Quinio C, Hvostoff C. Dental care of disabled people: Descriptive cross-sectional study of social and medico-social establishments. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:17-28. [PMID: 38040641 DOI: 10.3917/spub.hs1.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The first objective of this study, concerning the intervention of a dentist in social and medico-social establishments (SMSE), was to diagnose the oral care needs of disabled people (DP). The second objective was to raise awareness of a prevention and follow-up protocol among caregiving staff. We carried out this descriptive cross-sectional study from October 2016 to October 2018, in twenty SMSEs in Essonne. It involved a cohort of 663 volunteer DP, i.e., over 81 percent of the DP accommodated in these establishments. We analyzed DP’s oral hygiene and health indicators, as well as changes in professional practices following simulation workshops, using Pearson’s Chi-square test and Cramer’s test to assess the existence of relationships between variables and their intensity, respectively. Of the 96 percent of DP who accepted a full screening, three-quarters had dental plaque and two-thirds had gingival inflammation, these pathologies being more frequent in the over-20s (p< 0.001 | Cramer’s V=0.26). Only 14 percent had good oral health. Six months later, seventeen SMSEs had recorded dental check-ups in their medical records, and eight SMSEs had introduced brushing after dinner and breakfast, compared with ten and seven respectively before the intervention. This study confirmed the need for SMSEs to carry out dental screening. The involvement of establishments in monitoring the oral hygiene of DP must be strengthened.
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Affiliation(s)
- Marianne Bracconi
- Association Appolline : chirurgien-dentiste. Croix-Rouge : chirurgien-dentiste
| | - Alain Michault
- Agence Régionale de santé, Paris, France : Chef de projet et Dataminer. Conservatoire National des Arts et Métiers, Paris, France : Enseignant-vacataire
| | - Catherine Rey-Quinio
- Agence Régionale de santé, Paris, France : Conseillère médicale Politique du handicap – Référente Maladies Rares
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15
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López RM, Bovaird I, Olmo González B, Abu-Eid R. Dental student readiness to treat special care patients upon graduation. SPECIAL CARE IN DENTISTRY 2023; 43:869-882. [PMID: 37186085 DOI: 10.1111/scd.12866] [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: 04/27/2022] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION There has been a global increase in patients with special needs. Undergraduate dental curricula need to adjust to meet the needs of these patients. This study aimed to identify how confident final year dental students felt about treating patients with special needs upon graduation and evaluate the influence that the curriculum had on their preparedness based on competencies outlined by the International Association for Disability and Oral Health (iADH). METHODS A questionnaire was administered to final year dental students at two different Universities in Scotland and in Spain to: (1) evaluate how prepared students felt when treating patients with special needs and (2) assess the competencies outlined by iADH. RESULTS The response rate was 18.4% (30/163 students). Overall, 83.3% of the students (n = 25) perceived they would benefit from more practical sessions with patients with learning and physical disabilities to improve their clinical management of these patients. 53.3% (n = 16) didn't feel that had the knowledge to properly treat all special care dentistry (SCD) patients upon graduation (scored 5 or 6 on the IADH competency framework). 83.3% of the students (n = 25) felt that the mode of teaching should be problem-based complemented with small group seminars. CONCLUSION Students from both Universities agreed that more clinical practice might be required for them to further their skills to treat special needs patients upon graduation, which correlates with the need to have more practical sessions to consolidate competency 4 (communication skills with SCD) and competency 6 (clinical management of patients requiring SCD).
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Affiliation(s)
| | - Iain Bovaird
- Institute of Dentistry, University of Aberdeen, Aberdeen, UK
| | - Belisa Olmo González
- Special Care and Oral Medicine Department, Dental School. Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
| | - Rasha Abu-Eid
- Institute of Dentistry, University of Aberdeen, Aberdeen, UK
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16
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Sasikala J, Sukhabogi JR, Doshi D, Susmitha TS, Billa AL. Correlation of dental pain and pain catastrophizing with oral health status among physically disabled. J Clin Exp Dent 2023; 15:e855-e860. [PMID: 37933400 PMCID: PMC10625677 DOI: 10.4317/jced.60816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/11/2023] [Indexed: 11/08/2023] Open
Abstract
Background Physical disability results in impaired mobility, leading to increased dependency on others and may also have a negative impact on ones general and oral health. Moreover, such individuals could be at a greater risk of being prone to chronic pain conditions. A person's ability to cope with pain is a consistent and one of the most important predictors of clinical outcome. Catastrophization is known to be a maladaptive coping behaviour that could negatively influence such outcomes. Material and Methods A cross-sectional study was conducted among 229 physically disabled individuals at Home for Disabled, Bansilalpet, Secunderabad. Extent of Physical disability was measured using Barthel index of Activities of Daily Living (ADL), type and severity of dental pain was assessed using the short form McGill Pain Questionnaire and catastrophizing using the Pain Catastrophizing Scale (PCS). Dentition status and periodontal status were assessed using the World Health Organization assessment form. Results Caries prevalence of the population was 39.7% with a mean DMFT score of 2.8±4.09. Pain catastrophizing showed positive significant (p<0.05) correlation with sensory pain(r=0.182), visual analog scale(r=0.168), pain severity(r=0.161) and DMFT (r=0.4). It had significant negative correlation with ADL and bleeding gums. Conclusions In this study it was apparent that irrespective of the dependency levels, dentition status had a significant effect on pain catastrophizing level of the individuals. Key words:Disability, Oral Health, Catastrophizing.
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Affiliation(s)
- Jummala Sasikala
- Department of Public Health Dentistry, Government Dental College & Hospital, Hyderabad, Afzalgunj Road, near police station, Hyderabad, Telangana, India
| | - Jagadeeswara-Rao Sukhabogi
- Department of Public Health Dentistry, Government Dental College & Hospital, Hyderabad, Afzalgunj Road, near police station, Hyderabad, Telangana, India
| | - Dolar Doshi
- Department of Public Health Dentistry, Government Dental College & Hospital, Hyderabad, Afzalgunj Road, near police station, Hyderabad, Telangana, India
| | - Turaga-Sai Susmitha
- Department of Public Health Dentistry, Government Dental College & Hospital, Hyderabad, Afzalgunj Road, near police station, Hyderabad, Telangana, India
| | - Aishwarya-Lakshmi Billa
- Department of Public Health Dentistry, Government Dental College & Hospital, Hyderabad, Afzalgunj Road, near police station, Hyderabad, Telangana, India
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17
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Faulks D. Oral health inequalities and disability: Closing the gap. Community Dent Oral Epidemiol 2023. [PMID: 36732929 DOI: 10.1111/cdoe.12843] [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: 09/26/2022] [Revised: 01/03/2023] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
The social determinants of health impact disproportionately on disabled people creating a cumulative risk of unequal oral health outcomes, compounded by impairment. Problems in early life, education and employment, poor social status and support, social exclusion, poverty and stress characterize the life course of many disabled people. Ableism and exclusion combine to ensure that disabled voices are rarely heard, ignorance and indifference lead to prejudice in policy-making and enforcement and negative media attitudes fuelled by political austerity lead to stigmatization. Yet, the health disparities experienced by disabled people are still perceived as being uniquely caused by a medical condition or impaired body function, excluding disabled people from the inequalities discourse. In parallel, the influence of medical conditions within other marginalized groups are minimized (e.g. mental health), leading to the underestimation of the impact of disability on oral health generally. The common ground between all groups subject to oral health inequalities can be conceptualized using the WHO International Classification of Functioning. Outcomes for all might be improved by emphasizing this common ground; by considering disability as a primary variable, such as gender or age; by identifying disabled people within existing inequalities research; and by explicitly including disabled people in future research.
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Affiliation(s)
- Denise Faulks
- Université Clermont Auvergne, Centre de Recherche en Odontologie Clinique (CROC), Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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18
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Chavis SE, Roth E, Dababnah S, Tepper V, Badawi DG, Mullins CD. Qualitative inquiry from multiple perspectives of barriers and facilitators of oral health care for adults with disabilities. SPECIAL CARE IN DENTISTRY 2023; 43:47-55. [PMID: 35636426 PMCID: PMC10644716 DOI: 10.1111/scd.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 01/29/2023]
Abstract
AIMS Adults with special health care needs (ASHCN) face significant disparities in access to oral health care and subsequent health outcomes, resulting from several etiologies. This study investigated perspectives of patients, caregivers, and providers to better understand care barriers and facilitators for ASHCN. METHODS We conducted 26 semi-structured interviews with a purposive sample from an academic clinic specializing in oral health care for ASHCN with disabilities [patients (N = 4), caregivers (N = 8), and providers (N = 14)], and thematically analyzed transcripts for care barriers and facilitators. RESULTS Three overarching themes that encompassed overlapping barriers and facilitators of oral health care for ASHCN emerged: relational aspects, provider training/experience, and infrastructure aspects. Themes include intersecting perceptions of factors that hinder or help oral health care and management of ASHCN. CONCLUSIONS Building relationships with patients, inherent empathetic provider characteristics, and accommodating clinical infrastructure are imperative to facilitate oral health care for ASHCN. The primary themes revealed in this study are facilitators to care when they are present, and barriers to care when they are absent. No individual theme stands alone as a single contributor to quality care, and the provision of care for ASHCN relies on coordination of providers, patients, caregivers, and the overarching infrastructure.
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Affiliation(s)
- Sydnee E. Chavis
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Erin Roth
- School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | - Sarah Dababnah
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Vicki Tepper
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Deborah G. Badawi
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - C. Daniel Mullins
- School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
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19
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Berens JC, Tsami L, Lerman DC, Matteucci M, Fray DF, Warner BF, Keehan LA, Staggers KA, Peacock C. Preliminary Results of an Interdisciplinary Behavioral Program to Improve Access to Preventative Dental Care for Adults With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:504-519. [PMID: 36454615 DOI: 10.1352/1934-9556-60.6.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 02/16/2022] [Indexed: 06/17/2023]
Abstract
Adults with intellectual and developmental disabilities (AIDD) experience significant oral health disparities, partially due to perceived behavioral issues. This article describes the preliminary outcomes of a developing interdisciplinary (dental, medical, behavioral) program involving a behavioral intervention for AIDD previously receiving preventative dental care with sedation, general anesthesia, or protective stabilization (SAS). After a baseline assessment, a board-certified behavior analyst implemented increasingly complex behavioral interventions during simulated dental visits. Prior to COVID-19 pandemic-related restrictions, there were 32 active participants; 15 (46.9%) successfully completed a focused, real dental exam with simple behavioral interventions and 17 (53.1%) remain in treatment. These preliminary results suggest that many AIDD previously receiving SAS may participate in a preventative dental exam with minimal behavioral supports, if given the opportunity.
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Affiliation(s)
| | - Loukia Tsami
- Loukia Tsami, Dorothea C. Lerman, and Marissa Matteucci, University of Houston-Clear Lake
| | - Dorothea C Lerman
- Loukia Tsami, Dorothea C. Lerman, and Marissa Matteucci, University of Houston-Clear Lake
| | - Marissa Matteucci
- Loukia Tsami, Dorothea C. Lerman, and Marissa Matteucci, University of Houston-Clear Lake
| | - David F Fray
- David F. Fray and Ben F. Warner, The University of Texas Health Science Center at Houston School of Dentistry
| | - Ben F Warner
- David F. Fray and Ben F. Warner, The University of Texas Health Science Center at Houston School of Dentistry
| | - Laura A Keehan
- Laura A. Keehan, Kristen A. Staggers, and Cynthia Peacock, Baylor College of Medicine
| | - Kristen A Staggers
- Laura A. Keehan, Kristen A. Staggers, and Cynthia Peacock, Baylor College of Medicine
| | - Cynthia Peacock
- Laura A. Keehan, Kristen A. Staggers, and Cynthia Peacock, Baylor College of Medicine
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20
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Matteucci M, Lerman DC, Tsami L, Boyle S. Remote Training of Dental Students and Professionals to Promote Cooperative Behavior in Patients with Intellectual and Developmental Disabilities. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2022; 35:59-79. [PMID: 35400985 PMCID: PMC8976110 DOI: 10.1007/s10882-022-09844-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 05/26/2023]
Abstract
Many individuals diagnosed with intellectual and developmental disabilities (IDD) are uncooperative during routine dental exams, leading to poor oral health in this population. Few studies have evaluated methodologies for preparing dental students and professionals to work effectively with patients diagnosed with IDD. In this study, experimenters used remote behavioral skills training (BST) to train dental students and professionals how to implement a practical intervention that included tell-show-do, contingent praise, and noncontingent reinforcement. Results suggested that group training conducted via videoconferencing was effective for teaching six of seven participants to implement the intervention in the absence of post-training feedback. This approach appears useful for quickly and efficiently training current and future dental professionals to implement behavior techniques to promote patient compliance.
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Affiliation(s)
- Marissa Matteucci
- Clinical, Health, Applied Sciences, University of Houston, Clear Lake, 2700 Bay Area Blvd., TX 77058 Houston, USA
- Autism Society of North Carolina, Charlotte, USA
| | - Dorothea C. Lerman
- Clinical, Health, Applied Sciences, University of Houston, Clear Lake, 2700 Bay Area Blvd., TX 77058 Houston, USA
| | - Loukia Tsami
- Clinical, Health, Applied Sciences, University of Houston, Clear Lake, 2700 Bay Area Blvd., TX 77058 Houston, USA
| | - Samantha Boyle
- Clinical, Health, Applied Sciences, University of Houston, Clear Lake, 2700 Bay Area Blvd., TX 77058 Houston, USA
- Action Behavior Centers, Houston, USA
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21
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Mulcahy A, Streed CG, Wallisch AM, Batza K, Kurth N, Hall JP, McMaughan DJ. Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052588. [PMID: 35270279 PMCID: PMC8909748 DOI: 10.3390/ijerph19052588] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/10/2022]
Abstract
Disabled adults and transgender people in the United States face multiple compounding and marginalizing forces that result in unmet healthcare needs. Yet, gender identity among disabled people has not been explored, especially beyond binary categories of gender. Using cross-sectional survey data, we explored the rates of disability types and the odds of unmet healthcare needs among transgender people with disabilities compared to cisgender people with disabilities. The rates of disability type were similar between transgender and cisgender participants with two significant differences. Fewer transgender participants identified physical or mobility disability as their main disability compared to cisgender participants (12.31%/8 vs. 27.68/581, p < 0.01), and more transgender participants selected developmental disability as their main disability compared to cisgender participants (13.85%/9 vs. 3.67%/77, p < 0.001). After adjusting for sociodemographic characteristics, the odds of disabled transgender participants reporting an unmet need were higher for every unmet need except for preventative services.
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Affiliation(s)
- Abigail Mulcahy
- Center to Improve Veteran Involvement in Care, Portland VA Healthcare System, Portland, OR 97239, USA
- Correspondence:
| | - Carl G. Streed
- Section of General Internal Medicine, Boston University School of Medicine, Center for Transgender Medicine and Surgery, Boston Medical Center, Boston, MA 02118, USA;
| | - Anna Marie Wallisch
- Juniper Gardens Children’s Project, University of Kansas, Lawrence, KS 66045, USA;
| | - Katie Batza
- Women, Gender, and Sexuality Studies, University of Kansas, Lawrence, KS 66045, USA;
| | - Noelle Kurth
- Institute for Health and Disability Policy Studies, Life Span Institute, University of Kansas, Lawrence, KS 66045, USA;
| | - Jean P. Hall
- Research and Training Center on Independent Living and The Institute for Health and Disability Policy Studies, Lawrence, KS 66045, USA;
| | - Darcy Jones McMaughan
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA;
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22
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Kammer PV, Moro JS, Martins-Júnior PA, Cardoso M, Bolan M, Santana CM. The 100 most-cited papers in dentistry for individuals with neurodevelopmental disorders: Bibliometric profile of scientific research. SPECIAL CARE IN DENTISTRY 2021; 42:369-375. [PMID: 34856008 DOI: 10.1111/scd.12684] [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: 07/05/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/01/2022]
Abstract
AIM To conduct a bibliometric analysis of the top 100 most-cited papers in dentistry for individuals with neurodevelopmental disorders. METHODS AND RESULTS A search strategy was constructed and conducted at the Web of Science in the category of "Dentistry, Oral Surgery, and Medicine". The following information was extracted from each paper: title, authorship, year of publication, title of the journal, study subject, study design, age range of sample participants, type of disability, institution, country and continent, number of citations and citation density. Google Scholar and Scopus were used to crosscheck the number of citations of the most-cited papers. The VOSviewer software was used to generate bibliometric network maps. The papers received 4453 citations in Web of Science, ranging from 30 to 106 citations. Most papers were published by the USA (35%), had an observational design (78%) and the main subject was epidemiology (31%). Most studies focused on individuals with Down syndrome (34%) and Autism Spectrum Disorder (18%) and were published in the Journal of Periodontology (10%) and the Pediatric Dentistry Journal (7%). CONCLUSION Most of the studies included in this review were characterized as epidemiological studies. Future research should focus on behavior guidance, dental education, and access to dental services.
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Affiliation(s)
- Pedro Vitali Kammer
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Juliana Silva Moro
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Paulo Antônio Martins-Júnior
- Department of Child and Adolescent Oral Health, Federal University of Minas Gerais-Belo Horizonte, Minas Gerais, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Michele Bolan
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Carla Miranda Santana
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
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23
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Fosse C, Luo H, Laniado N, Okunseri C, Badner V. Dental access and expenditures for adults with intellectual and other disabilities. J Public Health Dent 2021; 81:299-307. [PMID: 34695877 DOI: 10.1111/jphd.12484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/30/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Individuals with disabilities experience greater barriers accessing health care services and have poorer oral health outcomes than those without disabilities. The aims of this study were to examine dental access, utilization, expenditures, and sources of payment between adults with intellectual disabilities (ID), other types of disabilities, and without disabilities. METHODS Secondary analyses of data from the 2017 Medical Expenditure Panel Survey (MEPS) allowed examination of dental access (being able to get dental care and receiving necessary dental care without delay), dental utilization (having a dental visit in the past year), total dental expenditures, and associated sources of payment between three groups of adults based on disability status using descriptive, bivariate, and multivariable statistics. RESULTS Adults with ID have 2.70 (95% CI: 2.03, 3.61) times the odds of being unable to get dental care and 2.88 (95% CI: 2.11, 3.94) times the odds of having to delay necessary dental care compared with adults without disabilities. No significant differences were observed in dental utilization or mean total dental expenditure between the three groups after adjusting for demographic and socioeconomic variables. Among adults who incurred a dental expenditure, adults with ID had a greater share of dental care paid for by Medicaid, and adults without disabilities had a greater share of dental care paid for by private insurance. CONCLUSIONS Despite similar mean total dental expenditures, reduced dental access reported by adults with ID suggests that this population experiences significantly greater challenges obtaining dental care. Adults with ID rely more heavily on Medicaid to finance dental care.
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Affiliation(s)
- Chelsea Fosse
- Department of Dentistry & OMFS, Jacobi Medical Center, NYC Health + Hospitals, New York City, New York, USA.,Health Policy Institute, American Dental Association, Chicago, Illinois, USA
| | - Huabin Luo
- Department of Public Health, East Carolina University, Greenville, North Carolina, USA
| | - Nadia Laniado
- Department of Dentistry & OMFS, Jacobi Medical Center, NYC Health + Hospitals, New York City, New York, USA
| | - Christopher Okunseri
- Department of Public Health, School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA
| | - Victor Badner
- Department of Dentistry & OMFS, Jacobi Medical Center, NYC Health + Hospitals, New York City, New York, USA
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24
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McGeown D, Mac Giolla Phadraig C, Whelehan D, Nunn JH. Dental decision-making under general anesthesia for patients with disabilities: A qualitative study. SPECIAL CARE IN DENTISTRY 2021; 42:20-27. [PMID: 34255384 DOI: 10.1111/scd.12631] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/31/2022]
Abstract
AIMS This paper explores the variables which influence decision-making processes in dentists providing dental care for people with disabilities under general anesthesia (GA). METHODS Face-to-face semi-structured interviews were undertaken on a purposive sample. Audio recordings were transcribed and checked for accuracy. Using thematic content analysis methods open codes were developed inductively. Codes were analyzed further by three authors adopting a deductive approach, leading to final coding, sorting and themes, subtheme and framework development. RESULTS Three themes emerged. The first theme explored Shared Decision Making, or lack thereof, as it influenced clinical reasoning. The second (Systematic, Analytical) and third (Intuition, and heuristics) themes explored features of clinical judgment as considered under dual process theory. Dentists primarily used intuitive decision-making processes and heuristic styled processes (or cognitive mental frames) assisted in intuition to extract teeth, without engaging type 2 processes. CONCLUSION The dentists experience subtle modifiers to their decision-making that ultimately promote extraction of teeth under GA for people with disabilities. Bias training, simulation and post-hoc reflection are examples of recommendations which may be used to improve decision-making in this area.
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Affiliation(s)
- Danielle McGeown
- Department Child and Public Health, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Dale Whelehan
- Discipline of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - June H Nunn
- Department Child and Public Health, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
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Lin IH, Huang MS, Wang PY, Huang TS, Chong SY, Chen SLS, Tsai HH. A comparative study of propofol alone and propofol combined with midazolam for dental treatments in special needs patients. Medicine (Baltimore) 2021; 100:e26199. [PMID: 34087890 PMCID: PMC8183838 DOI: 10.1097/md.0000000000026199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 05/12/2021] [Indexed: 01/04/2023] Open
Abstract
Although dental treatment with sedation is performed increasingly in special needs patients, data on adding midazolam to intravenous propofol sedation are very limited for this group. The purpose of this study was to identify the factors and procedure time associated with the use of intravenous sedation with propofol alone or propofol combined with midazolam in dental patients with special needs.This was a retrospective data analysis. The sedation medications and relevant covariates, including demographic parameters, disability levels, oral health conditions, dental procedures, treatment time, and side effects, of 718 patients with special needs were collected between April 2013 and September 2014. The unfavorable side effects by sedation types were reported. Factors associated with procedure time and the sedation medications were assessed with multiple logistic regression analyses.Of 718 patients, 8 patients experienced unfavorable side effects (vomiting, sleepiness, or emotional disturbance) after the dental procedures; the rate was 0.6% in the 509 patients who received propofol only. In 209 patients who received propofol and midazolam, 2.4% experienced the side effects. Sedation time was associated with body mass index (BMI) < 25 (adjusted odds ratio [aOR] = 1.45, 95% confidence interval [CI]: 1.04-2.04) and the performance of multiple dental procedures (aOR = 1.44, 95% CI: 1.06-1.97) but not associated with the sedation types. A significant odds ratio for the combined use of propofol and midazolam was shown for adolescents (aOR = 2.22, 95% CI: 1.28-3.86), men (aOR = 2.05, 95% CI: 1.41-2.98), patients with cognitive impairment (aOR = 1.99, 95% CI: 1.21-3.29), and patients undergoing scaling procedures (aOR = 1.64, 95% CI: 1.13-2.39).With the acceptable side effects of the use of propofol alone and propofol combined with midazolam, multiple dental procedures increase the sedation time and the factors associated with the combined use of propofol and midazolam are younger age, male sex, recognition problems, and the type dental procedure in the dental treatment of patients with special needs.
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Affiliation(s)
- I-Hsin Lin
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital
| | - Mao-Suan Huang
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital
| | - Pei-Yu Wang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University
| | - Ta-Sen Huang
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital
| | | | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University
| | - Hung-Huey Tsai
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
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Mastilovic G, Petrovic B, Peric T, Pantelinac J, Markovic E, Markovic D. Dental Treatment and Oral Rehabilitation for Adults With Intellectual Disability Under General Anesthesia. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gorana Mastilovic
- Faculty of Medicine, Dentistry Clinic of Vojvodina University of Novi Sad Novi Sad Serbia
| | - Bojan Petrovic
- Faculty of Medicine, Dentistry Clinic of Vojvodina University of Novi Sad Novi Sad Serbia
| | - Tamara Peric
- Department of Pediatric and Preventive Dentistry University of Belgrade Belgrade Serbia
| | - Jelena Pantelinac
- Faculty of Medicine, Dentistry Clinic of Vojvodina University of Novi Sad Novi Sad Serbia
| | | | - Dejan Markovic
- Department of Pediatric and Preventive Dentistry University of Belgrade Belgrade Serbia
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Medical Diagnoses, Mode of Residence, and Dental Treatment Demand under General Anesthesia in Special Needs Adults in Innsbruck, Austria. A Retrospective Breakdown of Four and a Half Years. Healthcare (Basel) 2021; 9:healthcare9030279. [PMID: 33806623 PMCID: PMC7998673 DOI: 10.3390/healthcare9030279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022] Open
Abstract
Regarding oral/dental care and attendance, special needs individuals depend on their caregivers' commitment. The purpose of this retrospective data analysis of adults who received dental general anesthesia (DGA) in Innsbruck, Austria, was a breakdown of demographic parameters (including the mode of accommodation/care), medical diagnoses (comprising intellectual/physical disablement (IPD) or psychiatric (anxiety) disorders (PDs)), and dental therapy performed under DGA. The sample was composed of 233 consecutive adults who underwent DGA from January 2015 to June 2019. Data were analyzed with descriptive and comparative statistics. In total, 133 (57.1%) subjects were male and 100 (42.9%) female; 176 (75.5%) had IPD and 57 (24.5%) PDs; 168 (72.1%) were living at private and 65 (27.9%) at nursing homes. Median age (IQR) was 35.6 (25.7-47.2) years. In the total sample, 5 (2-9) teeth were restored and 2 (0.5-6.5) teeth were extracted. Individuals with PDs had more teeth restored (p = 0.01) and extracted (p < 0.001) than individuals with IPD. Private home residents had more teeth restored (p < 0.001) but less teeth extracted (p = 0.003) than nursing home residents. Special needs individuals' oral health backlog should be tackled in private and institutional care modalities alike.
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Li H, Parish SL, Magaña S, Morales MA. Racial and Ethnic Disparities in Perceived Barriers to Health Care Among U.S. Adults With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 59:84-94. [PMID: 33543279 DOI: 10.1352/1934-9556-59.1.84] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 09/07/2017] [Indexed: 06/12/2023]
Abstract
Barriers to health care access can greatly affect one's health status. Research shows that U.S. adults with intellectual and developmental disabilities (IDD) have poor health and face barriers such as long waits for appointments. However, whether barriers differ by race and ethnicity has not been examined. We conducted a secondary data analysis using the 2002-2011 Medical Expenditure Panel Survey dataset, and compared perceived barriers of community-living U.S. adults with IDD in three racial and ethnic groups (White, Black, and Latinx). Specifically, we examined the top reasons for not having usual source of care, delaying or foregoing medical care. For Black and Latinx adults with IDD, the most-mentioned reasons for not having usual source of care, delaying or foregoing medical care were "don't like/don't trust doctors," "don't use doctors," and "don't know where to get care." In comparison, the White adults with IDD group's biggest perceived barriers were location and insurance related. All groups cited that being unable to afford care was a top reason for delaying or foregoing care. Policies/interventions to improve health care access in racial/ethnic minorities with IDD must first address the topic of developing trust between patients and the health professions. Insurance and the rising costs of care are also key areas that need attention.
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Affiliation(s)
- Henan Li
- Henan Li, Human Services Research Institute
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Macarevich Condessa A, Pilotto LM, Celeste RK, Hilgert JB. Use of dental services by disability status in Brazil in 2013. Community Dent Oral Epidemiol 2021; 49:471-477. [PMID: 33521999 DOI: 10.1111/cdoe.12623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/22/2020] [Accepted: 01/12/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the prevalence and factors associated with the use of oral health services in people with and without disabilities in Brazil. METHODS A cross-sectional study was used with the secondary data of 60,202 individuals from the Brazilian National Health Survey of 2013. The main exposure variable was 'Disability', and the main outcome was 'Dental service use'. Independent variables were selected using the modified Andersen and Davidson model, according to four groups: exogenous variables, primary determinants of oral health, health behaviours and oral health conditions. The analysis was based on a hierarchical approach stratified by 'disability (yes/no)', with multiple logistic regression incorporating sampling design. Interaction terms between the disability variable and covariates were tested in logistic regression models. RESULTS A total of 45.5% of the people without disabilities and 34.1% of those with disabilities visited the dentist in the last year. In the crude model, the nondisabled group used dental services more (OR = 1.61, 95%CI = 1.45-1.79), but the difference was no longer significant (OR = 1.18, 95%CI = 0.93-1.51) when adjusted by the health behaviour and oral health condition blocks. Determinants of dental use were similar among people with and without a disability. CONCLUSIONS No difference in dental service use according to disability status was found after adjusting for oral health conditions. Although edentulism is more prevalent among disabled people, they do not go to the dentist as regularly as nondisabled people. Health services should actively schedule maintenance visits to ensure that the needs of disabled individuals are fully addressed.
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Affiliation(s)
- Aline Macarevich Condessa
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciane Maria Pilotto
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Sermsuti-Anuwat N, Pongpanich S. Effectiveness of an individually tailored oral hygiene intervention in improving gingival health among community-dwelling adults with physical disabilities in Thailand. SPECIAL CARE IN DENTISTRY 2020; 41:202-209. [PMID: 33350502 DOI: 10.1111/scd.12554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/25/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022]
Abstract
AIMS Persons with physical disabilities require specific methods for sustaining good oral health. This study aimed to evaluate an individually tailored oral hygiene intervention program (IT-OHI) for improving gingival health among adults with disabilities. METHODS AND RESULTS A single group, quasi-experimental design with pre- and post-tests, conducted at a community club for disabled people in Thailand. This study included 145 adults with disabilities, aged 18-74 years. Trained caregivers provided IT-OHI program to all participants. Calibrated dentists assessed the gingival bleeding and dental plaque at baseline/pre-intervention (T0) and at 6 (T1) and 12 (T2) weeks post-intervention. The outcomes were analyzed using the Friedman test, Cochran's Q test, and Binary logistic regression. There were significant decreases in bleeding on probing scores (P < .001) and plaque control record scores (P < .001) throughout the study. However, considering the individual periods, values between T1 and T2 did not improve. Additionally, the IT-OHI program's protective effect was more substantial among the male participants at 12 weeks post-intervention (odds ratio = 0.094, P = .027) than among the females. CONCLUSION The IT-OHI program had partial effectiveness in improving gingival health and reducing dental plaque accumulation in a group of Thai people with physical disabilities; however, the long-term impact remains unclear.
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Hassona Y, Aljafari A, Atef A, Abdalfattah L, Hosey MT. Failure on all fronts: Qualitative analysis of the oral health care experience in individuals with intellectual disability. SPECIAL CARE IN DENTISTRY 2020; 41:235-243. [PMID: 33264435 DOI: 10.1111/scd.12550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore the oral health care experience of individuals with intellectual disability and their families. METHODS A qualitative approach utilising face-to-face semi-structured interviews with parents of individuals with intellectual disability. All interviews were audio recorded and transcribed verbatim, and Qualitative Framework Analysis was used to present the results. RESULTS Twenty-six parents of 26 individuals with intellectual disability were interviewed. The interviewees were 10 males and 16 females, and their average age was 46.4 ± 11.2 years (range 28-66). The average age of individuals with intellectual disability was 17.9 ± 9.2 years (range 6-48), and there were 11 (42.3%) males and 15 (57.7%) females. The interviewees reported that challenges to oral health care do occur on multiple levels: (a) home environment; (b) primary dental care; (c) secondary dental care facilities; (d) health and education policies and systems; and (e) societal views on individuals with intellectual disability. CONCLUSION Individuals with intellectual disability and their families are being failed at multiple levels of oral health care, leaving parents feeling frustrated, isolated, and sometimes helpless. Collaborative efforts are needed to train families to prevent oral health disease at home, establish better primary and secondary oral health care systems, and overcome wider cultural, social, and economic barriers.
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Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ahmad Aljafari
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ala'a Atef
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Leen Abdalfattah
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Marie Therese Hosey
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
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Ward LM, Cooper SA, McSkimming P, Greenlaw N, Pacitti C, Gibson J, Henderson A, Stanley B, Pell J, Kinnear D. Dental attendance, restoration and extractions in adults with intellectual disabilities compared with the general population: a record linkage study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:980-986. [PMID: 32996662 DOI: 10.1111/jir.12786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Oral health may be poorer in adults with intellectual disabilities (IDs) who rely on carer support and medications with increased dental risks. METHODS Record linkage study of dental outcomes, and associations with anticholinergic (e.g. antipsychotics) and sugar-containing liquid medication, in adults with IDs compared with age-sex-neighbourhood deprivation-matched general population controls. RESULTS A total of 2933/4305 (68.1%) with IDs and 7761/12 915 (60.1%) without IDs attended dental care: odds ratio (OR) = 1.42 [1.32, 1.53]; 1359 (31.6%) with IDs versus 5233 (40.5%) without IDs had restorations: OR = 0.68 [0.63, 0.73]; and 567 (13.2%) with IDs versus 2048 (15.9%) without IDs had dental extractions: OR = 0.80 [0.73, 0.89]. Group differences for attendance were greatest in younger ages, and restoration/extractions differences were greatest in older ages. Adults with IDs were more likely prescribed with anticholinergics (2493 (57.9%) vs. 6235 (48.3%): OR = 1.49 [1.39, 1.59]) and sugar-containing liquids (1641 (38.1%) vs. 2315 (17.9%): OR = 2.89 [2.67, 3.12]). CONCLUSION Carers support dental appointments, but dentists may be less likely to restore teeth, possibly extracting multiple teeth at individual appointments instead.
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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
| | - P McSkimming
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - N Greenlaw
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - C Pacitti
- Leverndale Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Gibson
- School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital and School, Glasgow, UK
| | - A Henderson
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - B Stanley
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - J Pell
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - D Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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CAVA-ARANGOITIA OCJ, GUEVARA-CANALES JO, MORALES-VADILLO R, CAVA-VERGIÚ CE, RIBERA-URIBE M, MAYO-ORTEGA L. PREDICTIVE INDICATORS FOR MANAGING DENTAL CARE IN PATIENTS WITH DIFFERENT ABILITIES. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.776746] [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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Gysling SP, Taiclet LM, Polk DE. Associations between practice patterns and dental education in special care dentistry. J Dent Educ 2020; 84:1084-1090. [DOI: 10.1002/jdd.12254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 11/07/2022]
Affiliation(s)
| | - Lynne M. Taiclet
- Dental Medicine University of Pittsburgh School of Dental Medicine Pittsburgh Pennsylvania USA
| | - Deborah E. Polk
- Dental Public Health University of Pittsburgh School of Dental Medicine Pittsburgh Pennsylvania USA
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Abstract
Systemic and structural barriers limit dental health for individuals with special healthcare needs (SHCN), who have poorer dental hygiene, higher rates of dental disorders, and less access to oral care. We aimed to understand these barriers directly from the patient and caregiver population as well as review the literature on oral health of individuals with SHCN. We reviewed the literature on individuals and caregivers of those with SHCN to identify barriers to dental healthcare faced by these individuals. We focused on clinical and educational interventions to support clinicians treating this population. For the literature review, PubMed, Google, and Google Scholar were searched. We also relied upon the knowledge gained during the course of routine clinical care and patient advocacy activities. Published manuscripts were searched for the following Medical Subject Heading (MeSH) term: "Dental Care for Disabled" and the following subheading: pharmacology, adverse effects, ethics, methods, standards, and therapy. Relatively few dentists have formal training on caring for those with SHCN. Barriers faced by these individuals include accessibility, comorbidities, communication challenges, and barriers to home oral hygiene. Strong care coordination and communication between dentists, caregivers, and other providers is essential for positive outcomes. Our current dental healthcare system has failed to meet the needs of those with SHCN. The comfort and dignity of the patient are of paramount importance.
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Teo CHK, Mahesh MN, Lim GXD. Oral health status and barriers to care in a multiethnic mixed disability center: Rethinking disability community dental services. SPECIAL CARE IN DENTISTRY 2020; 40:344-355. [DOI: 10.1111/scd.12483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Cher Hwei Kalinda Teo
- Nanyang PolytechnicOral Health Therapy 180 Ang Mo Kio Ave 8, 569830 Singapore
- Health Promotion BoardSchool Dental Service Second Hospital Avenue #04‐00, Health Promotion Board, 168937 Singapore
| | | | - Guang Xu David Lim
- Nanyang PolytechnicOral Health Therapy 180 Ang Mo Kio Ave 8, 569830 Singapore
- National Dental Centre SingaporeGeriatrics and Special Care Dental Centre 5 Second Hospital Avenue, 168938 Singapore
- Buddhist Compassion Relief Tzu Chi FoundationTzu Chi Free Clinic (Dental) Block 90 Redhill Close #01‐400, 150090 Singapore
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Kılınç G, Açıkgöz A, Koca B, Toyran N, Güldaş N. An evaluation of the effectiveness of dental health training administered at a health services school. Health Promot J Austr 2020; 32:295-302. [PMID: 32337756 DOI: 10.1002/hpja.353] [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: 01/10/2020] [Revised: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 11/08/2022] Open
Abstract
ISSUE ADDRESSED The aim of this study was to determine the knowledge and behaviour of health technician students to determine their oral health (OH) status, and to evaluate the effectiveness of a structured education administered for increasing OH awareness. METHODS Interventional research was performed between December 2018 and March 2019 on 445 Vocational School of Health Services students in … University. Questionnaires were conducted under observation. The first questionnaire (Q1) included socio-demographic characteristics, OH knowledge level, attitudes and behaviours. One month after the OH training was given to the students, the same questions in Q1 were asked again in the second questionnaire (Q2). Dental caries and Simplified Oral Hygiene Index (OHI-S) status were determined by a dentist via a clinical oral examination. RESULTS Of the 445 students, 416 (93.5%) participated in the study and completed the Q1 and Q2 questionnaires. A total of 277 (66.6%) students were female and 139 (33.4%) were male, with the age range being 17-33 years (average: 19.2 ± 1.86 years). Of the 416 students who answered the Q1 and Q2 questionnaires, 385 received oral examinations. While the Q1 knowledge score was 7.06 ± 2.08, the Q2 was found to be 12.36 ± 2.90 (P < .001). It was seen that 119 (30.9%) students who had poor OHI-S and 120 (31.2%), had a mean number of decayed, missing and filled teeth (DMFT) value of 6 and above. It was found that the females had better OH values than males (P < .001) and smokers had worse OH values overall (P < .016). CONCLUSION It was observed that the health technician students had a low level of knowledge about OH before the training but after receiving the training, their knowledge, attitude and behaviour changed positively. SO WHAT?: It was concluded that the OH education given to students caused a positive change in their behaviour, attitude and knowledge.
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Affiliation(s)
- Gülser Kılınç
- Oral Dental Health Techniques Program, Vocational School of Health Services, Dokuz Eylul University, Izmir, Turkey
| | - Ayla Açıkgöz
- Medical Documentation and Secretariat, Vocational School of Health Services, Dokuz Eylul University, Izmir, Turkey
| | - Bennur Koca
- First and Emergency Aid Program, Vocational School of Health Services, Dokuz Eylul University, Izmir, Turkey
| | - Neslihan Toyran
- Medical Laboratory Techniques Program, Vocational School of Health Services, Dokuz Eylul University, Izmir, Turkey
| | - Nevcivan Güldaş
- Faculty of Medicine, Research Laboratory, Dokuz Eylul University, Izmir, Turkey
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Bennadi D, Konekeri V, Maurya M, Reddy V, Satish G, Reddy CVK. Oral hygiene negligence among institutionalized mentally disabled children in Mysore city-A call for attention. J Family Med Prim Care 2020; 9:2045-2051. [PMID: 32670963 PMCID: PMC7346966 DOI: 10.4103/jfmpc.jfmpc_720_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/17/2019] [Accepted: 10/31/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Oral health is integral part of general health. In certain conditions especially among mentally disabled, oral health is neglected. Studies have shown that mentally disabled population has the risk of poor oral health. People with disabilities deserve the same opportunities for oral health and hygiene as those who are healthy, but sadly dental care is the most common unmet health care need of the disabled people. METHODOLOGY This comparative, descriptive cross-sectional study was conducted among institutionalized mentally disabled and normal children of age group 6-13 years in Mysore city. RESULTS Majority of mentally disabled children, that is, 36.73% (n = 180), had poor oral hygiene when compared with normal children, that is, 9.18% (n = 45). This difference was statistically highly significant (P < 0.000). The significant differences in the gingival status and severity of mental disability were seen (P < 0.001). The result showed that the gingival health worsens with increase in the severity of mental disability. CONCLUSION The present study showed the dental negligence among mentally disabled children where the parents, caretakers, and dentists are responsible. Oral health promotion programs should be conducted for special group children, their parents, as well as caretakers.
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Affiliation(s)
- Darshana Bennadi
- Department of Public Health Dentistry, Sree Siddhartha Dental College and Hospital, Sri Siddhartha Academy Higher Education, Agalkote, Tumkur, Karnataka, India
| | - Vinayaka Konekeri
- Department of Public Health Dentistry, Al-Azhar Dental College, Perumpillichira, P.O, Thodupuzha, Idukki, Kerala, India
| | - M Maurya
- Department of Public Health Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
| | - Veera Reddy
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bellary, Karnataka, India
| | - G Satish
- Ibn Sina National College for Medical Studies, Jeddah, KSA
| | - C. V. K. Reddy
- Department of Public Health Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
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Breslin L, Guerra N, Ganz L, Ervin D. Clinical Utility of Multisensory Environments for People With Intellectual and Developmental Disabilities: A Scoping Review. Am J Occup Ther 2020; 74:7401205060p1-7401205060p12. [PMID: 32078517 DOI: 10.5014/ajot.2020.037267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Adults with intellectual and developmental disabilities (IDD) are twice as likely as their peers without disabilities to have had a physical exam in the past year; however, as a result of challenging behavior during office visits, they are significantly less likely to have received recommended health screenings. Challenging behaviors in clinical settings have been identified as a barrier to providing adequate care for this population. OBJECTIVE This scoping review examined the within-session effects of multisensory environments (MSEs) on people with IDD to determine the clinical utility of MSEs for this population. DATA SOURCES Studies published between January 1, 2000, and August 1, 2018, were identified using Summon and Google Scholar. STUDY SELECTION Studies were included in the review if they systematically collected and reported data on within-session effects of an MSE intervention on people with IDD. FINDINGS Thirteen studies met criteria for this review: 4 with Level I evidence, 2 with Level II evidence, 3 with Level III evidence, and 4 with Level IV evidence. Studies examined the effects of MSEs on maladaptive behaviors, positive behaviors, distress and discomfort, activity and alertness states, and cost of care for people with IDD. CONCLUSION AND RELEVANCE Preliminary support was found for the use of MSEs in clinical settings to reduce anxiety and challenging behaviors in patients with IDD during clinical care. Further research is needed to determine the efficacy of MSEs for producing the effects described in this review. WHAT THIS ARTICLE ADDS The findings support the potential of MSEs as a tool that occupational therapy practitioners can use to support their clients with IDD who have sensory sensitivities in clinical settings. This article also highlights a multidisciplinary approach whereby medical providers and occupational therapy practitioners could work together in nontraditional ways to support this population.
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Affiliation(s)
- Lauren Breslin
- Lauren Breslin, BS, is Medical Student, Mayo Clinic Alix School of Medicine, Rochester, MN;
| | - Nichole Guerra
- Nichole Guerra, MS, DBA, is Director, Research Center, The Resource Exchange, Colorado Springs, CO
| | - Lori Ganz
- Lori Ganz, MS, OTR/L, is Director, Clinical Services, The Resource Exchange, Colorado Springs, CO
| | - David Ervin
- David Ervin, MA, is CEO, Jewish Foundation for Group Homes, Rockville, MD
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Ziegler ME, Pilcher E. Using the web to increase access to oral health care for patients with special health care needs in South Carolina: A replicable model. SPECIAL CARE IN DENTISTRY 2020; 40:160-167. [PMID: 31965591 DOI: 10.1111/scd.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/30/2022]
Abstract
AIM To create an accessible web-based resource of providers willing to provide dental services for patients with special health care needs (SCHNs). METHODS With a grant from The Duke Endowment, surveys were sent to dentists in South Carolina RESULTS: Data showed that the majority of providers expressed willingness to treat patients with one or more mild SHCN, but fewer expressed willingness to treat those with one or more moderate or severe SHCN. Additionally, the data showed that among general practitioners specifically, only one-third were willing to treat mild and moderate/severe manifestations of all categories listed. The number of practitioners willing to treat moderate to severe manifestations of SHCN and accept Medicaid and willing to take new Medicaid patients dropped even further. These results demonstrated a need to increase the number of providers in South Carolina who are willing to treat patients with SHCN, and a need to provide an accessible resource for patients with SHCN to be able to find these providers. Data collected populated the web-based resource for the Special Adult Network of Dentists url:www.sandsc.org1 CONCLUSION: This resource may be used by patients, caregivers, and health care providers and could be replicated in other states or designed as a national resource.
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Affiliation(s)
- Michelle E Ziegler
- Medical University of South Carolina, James B. Edwards College of Dental Medicine, Charleston, South Carolina
| | - Elizabeth Pilcher
- Medical University of South Carolina, James B. Edwards College of Dental Medicine, Charleston, South Carolina
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A special needs dentistry study of institutionalized individuals with intellectual disability in West Sumatra Indonesia. Sci Rep 2020; 10:153. [PMID: 31932596 PMCID: PMC6957682 DOI: 10.1038/s41598-019-56865-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/12/2019] [Indexed: 11/13/2022] Open
Abstract
People with intellectual disability have a higher risk of oral health problems. This study assessed the clinical oral health status and behaviors and treatment needs of people living in an institution in Padang, West Sumatra, Indonesia. We quantified oral health status of 65 individuals with intellectual disability using Oral Hygiene Index Simplified (OHIs), Angle’s classification of malocclusion, Community Periodontal Index and Treatment Need (CPITN), and decay index and also recorded their brushing behavior. We found that males had significantly lower OHIs (p < 0.001), more malocclusion (p < 0.001), greater caries number (p < 0.001), greater CPITN (p = 0.001) and higher need of dental treatment (p < 0.01) than females. Additionally, we found that high caries number was associated with poor OHIS, malocclusion, periodontal disease, and dependent brushing behavior (p < 0.001). The findings of this study imply that there is a gap in appropriate oral health care in individuals with intellectual disability. There should be a greater focus on providing appropriate oral health education to people with intellectual disability, improving the health literacy and quality of care of caregivers, and providing more dentists with specialized training in special needs dentistry.
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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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Phlypo I, Palmers E, Janssens L, Marks L, Jacquet W, Declerck D. The perception of oral health and oral care needs, barriers and current practices as perceived by managers and caregivers in organizations for people with disabilities in Flanders, Belgium. Clin Oral Investig 2019; 24:2061-2070. [PMID: 31485780 DOI: 10.1007/s00784-019-03071-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/29/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess the perception of oral health and oral care needs, barriers and current practices as perceived by managers and caregivers in organizations for people with disabilities in Flanders. MATERIALS AND METHODS Two questionnaires were developed, one for managers and one for caregivers. The questionnaires were distributed in all 570 organizations for people with disabilities in Flanders. The survey was carried out in February 2018. RESULTS Sixty-five managers completed the questionnaire and 63 of them could be linked to 57 unique organizations (10% of the contacted organizations). Managers perceived oral health to be better (P = 0.019) and mentioned less oral health needs (P = 0.049), when collaboration with a dentist was reported. When an oral health policy had been established in their organization, oral health was also perceived to be better (P = 0.048). The responses of 91 caregivers were included for analysis and 87 of them could be linked to 39 unique organizations (7% of contacted organizations). Seventy percent and 75% of the caregivers mentioned to have enough/comprehensive theoretical knowledge and practical skills, respectively, and 46% were interested in receiving oral health education. Most interest was shown in practical education and education customized to clients' needs. In organizations with an oral health project, more caregivers indicated that the organization was open to oral health questions than in organizations without such a project (97% compared with 81%; P = 0.045). When there was a collaboration with a dentist, the organization was more open to caregivers' questions (96% compared with 72%; P = 0.004) and a clear contact point was more readily available (81% compared with 48%; P = 0.004). Furthermore, caregivers were more interested to receive oral health education (P = 0.023) and mentioned to be more aware of the oral health of their clients (P = 0.015). About 23% and 30% of the caregivers indicated that guidelines were used in their organization for cleaning natural teeth and prostheses, respectively. CONCLUSIONS Despite the low response rate to the survey and reaching the management and caregivers of only 10% and 7% of the organizations respectively, this study indicates relevant issues to be incorporated when formulating recommendations for oral health promotion in people with disabilities in Flanders. CLINICAL RELEVANCE The results of this survey could affect the development of strategies and interventions to ameliorate the oral health of people with disabilities.
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Affiliation(s)
- Inès Phlypo
- Department of Oral Health Sciences, Special Needs in Dentistry, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Ellen Palmers
- Department of Oral Health Sciences, Special Needs in Dentistry, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.,Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Lynn Janssens
- Department of Oral Health Sciences, Special Needs in Dentistry, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Luc Marks
- Department of Oral Health Sciences, Special Needs in Dentistry, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Wolfgang Jacquet
- Department of Educational Science EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussel, Belgium.,Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussel, Belgium.,Department of Periodontology and Oral Implantology, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Dominique Declerck
- Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
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Yuki O, Furutani C, Mizota Y, Wakita A, Mimura S, Kihara T, Ohara M, Okada Y, Okada M, Nikawa H. Effect of bovine milk fermented with Lactobacillus rhamnosus L8020 on periodontal disease in individuals with intellectual disability: a randomized clinical trial. J Appl Oral Sci 2019; 27:e20180564. [PMID: 31365710 PMCID: PMC6690713 DOI: 10.1590/1678-7757-2018-0564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/17/2019] [Indexed: 12/22/2022] Open
Abstract
Studies on the oral health of individuals with intellectual disability (ID) have identified problems that include a high prevalence of periodontal disease. The use of probiotics to treat periodontal disease has been the focus of considerable research, and bovine milk fermented with Lactobacillus rhamnosus L8020 (L8020 yogurt) has been shown to reduce the oral prevalence of four periodontal pathogens.
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Affiliation(s)
- Oda Yuki
- Hiroshima University Hospital, Department of Special Care Dentistry, Hiroshima, Japan
| | - Chiaki Furutani
- Hiroshima University Hospital, Department of Special Care Dentistry, Hiroshima, Japan
| | - Yuika Mizota
- Hiroshima University Hospital, Department of Clinical Practice and Support, Division of Dental Hygiene, Hiroshima, Japan
| | - Atsuko Wakita
- Hiroshima University Hospital, Department of Clinical Practice and Support, Division of Dental Hygiene, Hiroshima, Japan
| | - Sumiyo Mimura
- Hiroshima University, Department of Oral Biology and Engineering, Hiroshima, Japan
| | - Takuya Kihara
- Tsurumi University, School of Dental Medicine, Department of Fixed Prosthodontics, Yokohama, Japan
| | - Masaru Ohara
- Hiroshima University Hospital, Department of Advanced General Dentistry, Hiroshima, Japan
| | - Yoshiyuki Okada
- Hiroshima University Hospital, Department of Special Care Dentistry, Hiroshima, Japan
| | - Mitsugi Okada
- Hiroshima University Hospital, Department of Special Care Dentistry, Hiroshima, Japan
| | - Hiroki Nikawa
- Hiroshima University, Department of Oral Biology and Engineering, Hiroshima, Japan
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Waldron C, Nunn J, Mac Giolla Phadraig C, Comiskey C, Guerin S, van Harten MT, Donnelly‐Swift E, Clarke MJ. Oral hygiene interventions for people with intellectual disabilities. Cochrane Database Syst Rev 2019; 5:CD012628. [PMID: 31149734 PMCID: PMC6543590 DOI: 10.1002/14651858.cd012628.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Periodontal (gum) disease and dental caries (tooth decay) are the most common causes of tooth loss; dental plaque plays a major role in the development of these diseases. Effective oral hygiene involves removing dental plaque, for example, by regular toothbrushing. People with intellectual disabilities (ID) can have poor oral hygiene and oral health outcomes. OBJECTIVES To assess the effects (benefits and harms) of oral hygiene interventions, specifically the mechanical removal of plaque, for people with intellectual disabilities (ID). SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 4 February 2019: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Register of Studies), MEDLINE Ovid, Embase Ovid and PsycINFO Ovid. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. The Embase search was restricted by date due to the Cochrane Centralised Search Project, which makes available clinical trials indexed in Embase through CENTRAL. We handsearched specialist conference abstracts from the International Association of Disability and Oral Health (2006 to 2016). SELECTION CRITERIA We included randomised controlled trials (RCTs) and some types of non-randomised studies (NRS) (non-RCTs, controlled before-after studies, interrupted time series studies and repeated measures studies) that evaluated oral hygiene interventions targeted at people with ID or their carers, or both. We used the definition of ID in the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). We defined oral hygiene as the mechanical removal of plaque. We excluded studies that evaluated chemical removal of plaque, or mechanical and chemical removal of plaque combined. DATA COLLECTION AND ANALYSIS At least two review authors independently screened search records, identified relevant studies, extracted data, assessed risk of bias and judged the certainty of the evidence according to GRADE criteria. We contacted study authors for additional information if required. We reported RCTs and NRSs separately. MAIN RESULTS We included 19 RCTs and 15 NRSs involving 1795 adults and children with ID and 354 carers. Interventions evaluated were: special manual toothbrushes, electric toothbrushes, oral hygiene training, scheduled dental visits plus supervised toothbrushing, discussion of clinical photographs showing plaque, varied frequency of toothbrushing, plaque-disclosing agents and individualised care plans. We categorised results as short (six weeks or less), medium (between six weeks and 12 months) and long term (more than 12 months).Most studies were small; all were at overall high or unclear risk of bias. None of the studies reported quality of life or dental caries. We present below the evidence available from RCTs (or NRS if the comparison had no RCTs) for gingival health (inflammation and plaque) and adverse effects, as well as knowledge and behaviour outcomes for the training studies.Very low-certainty evidence suggested a special manual toothbrush (the Superbrush) reduced gingival inflammation (GI), and possibly plaque, more than a conventional toothbrush in the medium term (GI: mean difference (MD) -12.40, 95% CI -24.31 to -0.49; plaque: MD -0.44, 95% CI -0.93 to 0.05; 1 RCT, 18 participants); brushing was carried out by the carers. In the short term, neither toothbrush showed superiority (GI: MD -0.10, 95% CI -0.77 to 0.57; plaque: MD 0.20, 95% CI -0.45 to 0.85; 1 RCT, 25 participants; low- to very low-certainty evidence).Moderate- and low-certainty evidence found no difference between electric and manual toothbrushes for reducing GI or plaque, respectively, in the medium term (GI: MD 0.02, 95% CI -0.06 to 0.09; plaque: standardised mean difference 0.29, 95% CI -0.07 to 0.65; 2 RCTs, 120 participants). Short-term findings were inconsistent (4 RCTs; low- to very low-certainty evidence).Low-certainty evidence suggested training carers in oral hygiene care had no detectable effect on levels of GI or plaque in the medium term (GI: MD -0.09, 95% CI -0.63 to 0.45; plaque: MD -0.07, 95% CI -0.26 to 0.13; 2 RCTs, 99 participants). Low-certainty evidence suggested oral hygiene knowledge of carers was better in the medium term after training (MD 0.69, 95% CI 0.31 to 1.06; 2 RCTs, 189 participants); this was not found in the short term, and results for changes in behaviour, attitude and self-efficacy were mixed.One RCT (10 participants) found that training people with ID in oral hygiene care reduced plaque but not GI in the short term (GI: MD -0.28, 95% CI -0.90 to 0.34; plaque: MD -0.47, 95% CI -0.92 to -0.02; very low-certainty evidence).One RCT (304 participants) found that scheduled dental recall visits (at 1-, 3- or 6-month intervals) plus supervised daily toothbrushing were more likely than usual care to reduce GI (pocketing but not bleeding) and plaque in the long term (low-certainty evidence).One RCT (29 participants) found that motivating people with ID about oral hygiene by discussing photographs of their teeth with plaque highlighted by a plaque-disclosing agent, did not reduce plaque in the medium term (very low-certainty evidence).One RCT (80 participants) found daily toothbrushing by dental students was more effective for reducing plaque in people with ID than once- or twice-weekly toothbrushing in the short term (low-certainty evidence).A benefit to gingival health was found by one NRS that evaluated toothpaste with a plaque-disclosing agent and one that evaluated individualised oral care plans (very low-certainty evidence).Most studies did not report adverse effects; of those that did, only one study considered them as a formal outcome. Some studies reported participant difficulties using the electric or special manual toothbrushes. AUTHORS' CONCLUSIONS Although some oral hygiene interventions for people with ID show benefits, the clinical importance of these benefits is unclear. The evidence is mainly low or very low certainty. Moderate-certainty evidence was available for only one finding: electric and manual toothbrushes were similarly effective for reducing gingival inflammation in people with ID in the medium term. Larger, higher-quality RCTs are recommended to endorse or refute the findings of this review. In the meantime, oral hygiene care and advice should be based on professional expertise and the needs and preferences of the individual with ID and their carers.
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Affiliation(s)
- Catherine Waldron
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | - June Nunn
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | | | - Catherine Comiskey
- Trinity College Dublin, University of DublinSchool of Nursing and Midwifery24 D'Olier StDublinIrelandD02 T283
| | - Suzanne Guerin
- University College DublinSchool of PsychologyDublinIrelandDO4 V1W8
| | - Maria Theresa van Harten
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | - Erica Donnelly‐Swift
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | - Mike J Clarke
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences, Block B, Royal Victoria HospitalGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
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Fernández-Feijoo J, Carro B, Branco A, García-Caballero L, Diniz M, Limeres J. The effect of dentist experience on the treatment of individuals with disability under general anesthesia. SPECIAL CARE IN DENTISTRY 2019; 39:281-286. [PMID: 31021466 DOI: 10.1111/scd.12380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/20/2019] [Accepted: 03/24/2019] [Indexed: 11/30/2022]
Abstract
AIMS The aim of the present work was to assess in patients with severe disability operated under general anesthesia whether the progressive acquisition of experience by the dental team affects the type of procedure performed and the duration of operations. METHODS AND RESULTS A study group of 911 patients who underwent dental treatment under general anesthesia between 1997 and 2014 was conformed. Information was collected from every patient including: dental diagnosis, dental procedures and duration of the operating times. To analyze the impact of the operators' experience, the study period was divided into three 6-year periods. The most prevalent systemic diagnosis was "mental disease and behavior disorders" (42.9%). The most common dental procedures were extractions and fillings. Fewer extractions were performed during the third 6-year period (p = .000). Compared with the other two periods, during the first period fewer composite fillings (p = .000 and p = .000, respectively) and more fissure sealants (p = .001 and p = .023, respectively) were performed. The number of amalgam fillings decreased progressively (p = .000). There was a statistically significant reduction in the mean duration of the operations between the first and third period (p = .002). CONCLUSION The dental team's experience entailed a significant reduction in the duration of operations.
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Affiliation(s)
- Javier Fernández-Feijoo
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Beatriz Carro
- Department of Anesthesia, University Complex of Santiago de Compostela, Spain
| | - Ana Branco
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Lucía García-Caballero
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Márcio Diniz
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Jacobo Limeres
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
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Couto P, Pereira PA, Nunes M, Mendes RA. Characterization of oral health in a Portuguese population with mild intellectual disability. SPECIAL CARE IN DENTISTRY 2019; 39:298-305. [PMID: 30990923 DOI: 10.1111/scd.12376] [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: 12/15/2018] [Revised: 02/20/2019] [Accepted: 03/22/2019] [Indexed: 12/01/2022]
Abstract
AIMS This study aims to characterize the hygiene habits, the self-perception of the need for treatment and the oral condition of a population with a disability. METHODS AND RESULTS This research is part of an observational, cross-sectional epidemiological study on oral health and quality of life of people with mild intellectual disabilities living in (or attending) institutions of the Central Region of Portugal that were affiliated with HUMANITAS (Portuguese Federation for Mental Disability) in 2016. A sociodemographic and oral health questionnaire, applied on the form of an interview to 240 individuals aged between 18 and 64 years, was used. Statistical analyses were performed using SPSS version 22.0. It was verified that 32.9% of the individuals had less than 20 teeth. Only 15% of all individuals used removable prosthesis. About 21% didn't do oral hygiene daily. Only 28.4% of the sample visited the dentist in the last 6 months. Note that 75.2% of the sample stated their need for dental treatment and less than half (37.4%) described their oral condition as good or superior. CONCLUSION Dental care among adults with intellectual disability is one of the most unattended health needs. Evidence suggests that inadequate oral health habits are more prevalent in the studied population than in the Portuguese population.
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Affiliation(s)
- Patrícia Couto
- Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - Paulo Almeida Pereira
- Department of Economics, Management and Social Sciences, Portuguese Catholic University, Viseu, Portugal
| | - Manuel Nunes
- Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - Rui Amaral Mendes
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
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Schnabl D, Guarda A, Guarda M, von Spreckelsen LMI, Riedmann M, Steiner R, Dumfahrt H. Dental treatment under general anesthesia in adults with special needs at the University Hospital of Dental Prosthetics and Restorative Dentistry of Innsbruck, Austria: a retrospective study of 12 years. Clin Oral Investig 2019; 23:4157-4162. [PMID: 30830265 DOI: 10.1007/s00784-019-02854-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 02/13/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Special needs patients are prone to insufficient oral care and subsequent caries or periodontitis. The aim of this retrospective study was the assessment of demand for restorative therapy and tooth extractions under general anesthesia in adults with intellectual and/or physical disablement (IPD) or psychiatric disorders (PDs) with inherent dentist phobia at the University Hospital of Innsbruck with regard to demographic factors. MATERIALS AND METHODS A total of 444 consecutive cases of scheduled dental general anesthesia (DGA) in adults from 2003 to 2014 were included. From patient files, demographic data, the presence of either IPD or a PD, attested by a mandatory certificate, and restorative therapy and tooth extractions performed under DGA were obtained. Data analysis was carried out by means of descriptive and comparative statistics. RESULTS Four hundred two cases (mean age 37.5 ± 13.87 years) assigned to 283 individuals with IPD and 42 cases (mean age 36.09 ± 13.03 years) assigned to 39 individuals with PDs arose in the observed period. Patients with PDs required significantly more restorations (in 7.98 ± 5.4 versus 5.34 ± 4.41 teeth; p = 0.002; Mann-Whitney U test) and extractions (of 4.86 ± 4.51 versus 2.6 ± 3.96 teeth; p < 0.001; Mann-Whitney U test) than patients with IPD. CONCLUSIONS Demand for dental treatment was high in the collective of special needs patients. Oral health status was worse in patients with PDs than in patients suffering IPD. CLINICAL RELEVANCE While in patients with severe disablement, DGA presents the only treatment option, specific preventive programs should be implemented for patients with minor disablement or dentist phobia. In these patients, alternative approaches should be promoted.
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Affiliation(s)
- Dagmar Schnabl
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria.
| | - Annachiara Guarda
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Maria Guarda
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | | | - Marina Riedmann
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Rene Steiner
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Herbert Dumfahrt
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
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Zhou N, Wong HM, McGrath C. Effectiveness of a visual‐verbal integration model in training parents and their preschool children with intellectual and developmental disabilities to dispense a pea‐sized amount of fluoridated toothpaste. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:657-665. [DOI: 10.1111/jar.12560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 10/08/2018] [Accepted: 10/22/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Ni Zhou
- Faculty of Dentistry The University of Hong Kong Hong Kong Pokfulam Hong Kong SAR China
| | - Hai Ming Wong
- Faculty of Dentistry The University of Hong Kong Hong Kong Pokfulam Hong Kong SAR China
| | - Colman McGrath
- Faculty of Dentistry The University of Hong Kong Hong Kong Pokfulam Hong Kong SAR China
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Mac Giolla Phadraig C, Nunn J, McCallion P, Donnelly-Swift E, van Harten M, McCarron M. Total tooth loss without denture wear is a risk indicator for difficulty eating among older adults with intellectual disabilities. J Oral Rehabil 2018; 46:170-178. [DOI: 10.1111/joor.12738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/18/2018] [Accepted: 10/19/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Caoimhin Mac Giolla Phadraig
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
| | - June Nunn
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
| | - Philip McCallion
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
- School of Social Work; Temple University; Philadelphia Pennsylvania
| | - Erica Donnelly-Swift
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
| | - Maria van Harten
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
| | - Mary McCarron
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
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