SUMMARY Forty‐five patients aged 3 to 22 who have handicapping conditions were examined to determine their oral hygiene leveis and periodontal treatment needs. This study shows that oral hygiene leveis for males and the older population were higher. Periodontal treatment needs were highly correlated to oral hygiene, and were much higher for males and older age groups. Various aspects were discussed and it was concluded that primary prevention is an immediate, although a partial solution. However, new aids and antibacterial solutions should be further investigated in this population to simplify plaque removal.

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SUMMARY Thirty‐nine patients, aged 3 to 22, who have handicapping conditions were examined twice in a range of 1 1/2 years to determine oral hygiene level, periodontal treatment needs, and level of caries. During this period, each patient was given periodontal treatment, including scaling, caries treatment, and oral health education, which also was given to hospital staff members. Findings showed a slight increase in the DMF rate, a minor improvement in oral hygiene, and a significant reduction in periodontal treatment needs. The results showed that without cooperation of the staff members, a dental education program would not succeed in this setting.

ANYhave indicated that children with mentally handicapping conditions have lower DMF scores when compared with children without handicapping conditions and even lower scores when compared with children with physical handicaps. Other ~t u d i e s~-~ have shown the level of restorative care for children with physically handicapping conditions to be much lower than care provided children with no handicapping conditions of the same age.The purpose of this study was to determine the prevalence of caries among a population of institutionalized physically handicapped children in Israel and to use the data to estimate the treatment and workforce needs for the restorative care identified. M E T H O D S A N D MATERIALSForty-three children who were hospitalized in a long-term orthopedic hospital and rehabilitation center for handicapped children in Jerusalem, were examined during a 2-week period to evaluate their dental needs and oral hygiene status. The population ranged in age from 3 to 22 and had a variety of handicapping conditions, including progressive muscular dystrophies, meningomyelocele, poliomyelitis, cerebral palsy, osteogenesis imperfecta, scoliosis, rheumatoid arthritis, and traumatic quadriplegia.Information was gathered from each patient or a hospital staff person regarding the age, gender, oral hygiene behavior patterns, and type of toothbrush used. Other demographic information included the number of years the patient had the handicapping condition, length of hospitalization, and the range of motion status or lack of coordination of arm and hand.The Quigley-Hein Oral Hygiene Index,7 a standard 0 to 5 rating scale and a topical disclosing solution were used to evaluate oral hygiene. The Decayed, Missing, Filled Index (DMF) for permanent dentition and decayed, erupted, filled index (def) for the primary dentition were used according to the criteria published by the World Health Organization.8 To evaluate Dental schools should devote more clinical time to addressing the needs of these patients and demonstrating nonpharmacologic behavior modification approaches.f treatment needs, the decayed category of both indexes was further subdivided into primary decay, restorable with alloy; secondary decay, restorable with alloy; decay, restorable with cast restoration; decay, nonrestorable (extraction); and decay, endodontic therapy, and cast restoration required. All examinations were performed by the same examiner using a dental chair with artificial light, a front surface mouth mirror, and no. 23 sickle-shaped explorer.Mean and standard deviation values for several variables were calculated in the usual manner. In addition, analysis of variance and a Pearson correlation coefficient analysis were also performed. A P-value of P < .05 was chosen as an acceptable level of significance. RESULTS

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