Study IDs oral health challenges of special needs adults

A comprehensive study using electronic dental records to profile the oral health status of adults with intellectual and developmental disabilities (I/DD) has concluded that access to specialized dental care alone is not sufficient to meet the community's substantial oral health needs.

The findings, published in the August issue of the Journal of the American Dental Association (JADA, Vol. 143:8, pp. 838-846), provide a foundation for further investigation into the significant oral health needs of adults with I/DD and the development of preventive oral health strategies, according to the authors, from Tufts University School of Dental Medicine (TUSDM) and Tufts University School of Medicine (TUSM).

The study of dental records of 4,732 people was conducted at the Tufts Dental Facilities Serving People with Special Needs, a network of Massachusetts dental clinics that provides oral healthcare to people with disabilities.

Each year, Tufts' program serves more than 7,000 patients at seven clinics in Massachusetts. The findings in the JADA study are the first of a three-part study conducted by principal investigators John Morgan, DDS, an associate professor in the department of public health and community service at TUSDM, and Paula Minihan, PhD, MPH, an assistant professor in the department of public health and community medicine at TUSM.

"People with intellectual and developmental disabilities are more likely to have poor oral hygiene, periodontal disease, and untreated tooth decay than the general population," Dr. Morgan stated in a university press release. "Our findings highlight the need for greater awareness of the unique and complex dental healthcare needs of this population. The roles of the patient, caregiver, and dental provider are all vital in developing preventive strategies to improve oral health."

Morgan and colleagues analyzed clinical and demographic data documented in electronic dental records during a one-year period. They investigated oral health conditions, age, gender, ability to receive dental examinations and procedures, level of disability, and type of residence. Of the 4,732 patients whose records were reviewed, 61% were reported to have a mild to moderate disability, and 39% were assessed as having a severe disability. Dental records revealed a high burden of oral disease, including dental caries, periodontitis, and missing teeth.

Nearly 25% of the patients had a limited ability to accept any dental intervention and required specialized resources, such as general anesthesia. Almost 40% of all patients able to accept dental treatment required some form of behavioral assistance. These behavioral challenges pose difficulties for dental staff when providing diagnostic and therapeutic procedures.

Further research is required to identify and develop risk-based preventive interventions to manage oral diseases for people with intellectual or developmental disabilities, and maximize the role of the dental professional, patient, and caregiver in promoting oral health, the study authors concluded.