SummaryBackground. The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging.Objectives. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Methods. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Results. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. Conclusions. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.

Background Individuals with Down syndrome exhibit particular oro-facial characteristics that may increase their risk of oral health problems. However, there is little research on the oral health of children and adults with Down syndrome and the way that oral health may affect Quality of Life (QoL). This study explored mothers’ perceptions of the oral health problems experienced by their children with Down syndrome and how these reported problems impacted the lives of the children and their families. Methods The study involved 20 in-depth, semi-structured interviews with mothers of children and adolescents aged 12–18 years with Down syndrome attending special care centres in Riyadh, Saudi Arabia. Results The predominant oral-health related problem reported by mothers was difficulty in speaking. Mothers also reported that tooth decay and toothache were problems that had undesirable effects on different aspects of their children’s QoL including: performing daily activities, emotional wellbeing, and social relationships. Poor oral health and functional problems had direct and indirect impacts on the family’s QoL as well. Conclusion Mothers perceived an array of QoL impacts from oral conditions, which affected their child with Down syndrome and the wider family.

This study aimed to assess, whether depression in adulthood was associated with self-reported chewing difficulties at older age, and examine whether the strength of the association differed according to the number of depression episodes in earlier adult life. We used Whitehall II study data from 277 participants who completed a questionnaire in 2011. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D) in 2003 and 2008. The association between CES-D depression and self-reported chewing ability was assessed using regression models adjusted for some socio-demographic factors. Participants with depression at some point in their earlier adulthood had an odds ratio (95% CI) of 2·01 (1·06, 3·82) for reporting chewing difficulties in older adulthood, compared to those without depression. The respective odds ratios were 1·42 (0·66, 3·04) for individuals with depression in only one phase, but 3·53 (1·51, 8·24) for those with depression in two phases. In conclusion, while further research is required, there was an association between depression and chewing difficulty that was independent of demographic and socio-economic characteristics. Furthermore, this increased odds for chewing difficulties was primarily among adults that experienced two episodes or a prolonged period of depression.

Introduction: Special needs children experience poorer oral health when compared to their compatriots. Moreover, Special Care School Children (SCSC) experience significant barriers to access proper oral health care. It has been found that they have high unmet oral health needs. Aim: The aim of this study was to assess the effectiveness of preventive oral health measures in a group of SCSC; boys, in Al-Kharj Governorate of Saudi Arabia. Materials and Methods: A longitudinal study was designed among SCSC in Al-Kharj Governorate of Saudi Arabia starting from October 2016 for a period of eight months.Only schools for boys were included in the study. Out of 936 students enrolled in the special needs education programme in 18 boys schools; 163 SCSC (boys) from eight primary schools were eventually included in the study. After the base line survey; the subjects were evaluated with predefined criteria at three monthly intervals until six months. The effectiveness of various preventive measures was evaluated for reduction in the risk of oral diseases. SCSC were divided into groups as per their specific health care need. Preventive oral health measures such as supervised tooth brushing with a fluoridated tooth paste was introduced with the help of teachers and parents of SCSC. Plaque levels were assessed by means of Plaque index. Various indices were used to measure dental caries including Decayed, Missing, and Filled Teeth (DMFT/dmft) as well as Decayed, Missing, and Filled Surfaces (DMFS/dmfs) index. The risk for dental caries was assessed by means of a cariogram model at the start and at the end of campaign. The data was computed using SPSS v20 programme. Means of the overall plaque score and the caries indices scores were calculated and compared among various special need groups among the SCSC. The significance level was set at p<0.05. Results: The overall mean plaque score of the group was 1.55. Plaque scores and mean decayed (D) component were significantly higher in intellectual disabilities as compared to physical disabilities. The mean DMFT and DMFS score was 3.2 and 6.42, respectively with mean decayed (D) component score of 2.67. There was no significant difference among caries prevalence and decayed (D) component among various groups of disabilities. Plaque index score reduced to 1.35 after three months and finally to 1.1 after six months. This was statistically significant (p<0.05). The actual chance to avoid new cavities in the cariogram increased from 5% to 73% at the end, for the SCSC boys. Conclusion: There was a significant decrease in the risk for oral diseases after incorporation of preventive oral health measures for SCSC.

As individuals with Down syndrome often suffer from oro-facial abnormalities which can affect their oral health as well as their and their family’s quality of life, this link was examined in the present study. Using a descriptive cross-sectional design, 63 parents of children with Down syndrome who attended two special daycare centres in Riyadh, Saudi Arabia, were surveyed using a self-administered validated questionnaire. The findings yielded by the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 17 revealed that in 34.9% children and 46% of their families, quality of life was affected by oral health. Moreover, 54% children experienced physical pain, which was severe in 22.2% of the cases. Further analyses revealed that families’ emotional lives were negatively affected by children’s oral health status. Therefore, as oral health in children with Down syndrome exerts significant adverse impacts on different aspects of their lives and those of their families, timely provision of required oral health care is warranted.

ObjectivesTo assess oral health and its implication on oral health-related quality of life (OHRQoL) among groups of foundling and delinquent children compared to mainstream children in Riyadh, Saudi Arabia.Materials and MethodsThis cross-sectional observational study was conducted on children in care houses and mainstream school-going children. The following variables were measured for each group: Demographic data (age, gender); subjective oral health condition; (OHRQoL); clinical oral health condition including the decayed, missing, and filled teeth (DMFT) index; pulpally involved, ulceration, fistula, and abscess (PUFA) index; Dental Aesthetic Index (DAI) for malocclusion, and traumatic dental injuries (TDI).Statistical AnalysisA one-way ANOVA test, Chi-square test, and Pearson correlation coefficient were used.ResultsThe total OHRQoL score was significantly higher for the delinquent compared to the mainstream group. In addition, the DMFT and mean PUFA scores were significantly higher for the delinquent group than the others. The DAI revealed statistical significance in occlusion status within the foundling and delinquent groups, and the prevalence of TDI was significantly higher in the delinquent vs. the mainstream group.ConclusionOral health status appeared to have an association with the OHRQoL among foundling, delinquent, and mainstream children.

Objective The aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. Methods The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t -test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. Results The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). Conclusion The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.

Objectives:To assess dentists' intention to manage drug users (DUs) and to evaluate the role of the theory of planned behavior (TPB) and continuing education (CE) in explaining this intention. Materials and Methods:A cross-sectional study was conducted in 2017, including dentists from three major Saudi cities. A questionnaire assessed personal and professional background and components of TPB: attitude, perceived social norms, perceived control and intention to manage DUs. Respondents expressed their agreement on a scale from 1 (disagree) to 7 (agree). Receiving CE to manage DUs was also assessed. Adjusted linear regression was used to assess the impact of the TPB constructs and receiving CE on dentists' intention. Results: Response rate = 72% (255/354), mean (SD) age = 35.2 (11.9). The mean (SD) for positive intention to manage DUs = 5.34 (1.37), negative attitude = 4.03 (1.10), positively perceived norms = 5.78 (1.06) and perception of no control = 4.45 (1.08). Only 9% received CE to manage DUs. Positive intention was associated with perception of positive norms (B = 0.73, 95% CI = 0.59, 0.87) and perception of no control (B = −0.47, 95% CI = −0.63, −0.32) but not with receiving CE (P = 0.58). Conclusion:In major Saudi cities, dentists' intention to manage DUs was positive and was explained by TPB components: perception of norms and perception of control.Modified and targeted CE is needed to address this problem. K E Y W O R D Sdentists, dentists/psychology, drug users, Saudi Arabia