Factors Associated With Periodontal Diseases and Oral Hygiene Status Among Community-Dwelling Adults With Physical Disabilities in Thailand: A Cross-Sectional Study

Abstract

OBJECTIVE: There is limited evidence concerning oral health among disabled people capable of independently performing oral hygiene practices. This study investigated factors associated with periodontal diseases and oral hygiene status among community-dwelling, working-age Thai adults with physical disabilities. 
 
 MATERIAL & METHODS: A cross-sectional study was conducted between 1st February to 15th March 2018 at the Community Center for Independent Living, a disability community club located in Pathum Thani province, Thailand. A total of 198 adults with physical disabilities completed self-report questionnaires. Occurrence of bleeding on probing and presence of dental plaque accumulation were obtained through full-mouth periodontal examinations by a trained and calibrated examiner. Univariate and multivariate binary logistic regression were performed. 
 
 RESULTS: Toothbrushing frequency of less than twice per day was associated with periodontal diseases (OR = 8.25, p = 0.001). Higher levels of sweets consumption (OR = 3.17, p = 0.003) and infrequent toothbrushing (OR = 4.26, p = 0.001) were related to poor oral hygiene. 
 
 CONCLUSIONS: Participants who performed improper oral health behaviors would suffer from periodontal diseases and poorer oral hygiene status. Although participants are capable of performing daily self-care, their physical limitation is a possible explanation for difficulty in appropriate personal oral hygiene practices, which can lead to a lower quality of oral cleanliness. Therefore, professional oral health education and personal oral hygiene instruction tailor-fit to their specific needs are necessary to increase the quality of toothbrushing practices and proper oral health behaviors among persons with physical disabilities.

Effectiveness of an individually tailored oral hygiene intervention in improving gingival health among community‐dwelling adults with physical disabilities in Thailand

“…Following the program, all participants received a leaflet containing oral hygiene instructions, an oral health care self‐education video, and a booklet on the Thai Universal Healthcare Coverage (UHC) plan of dental care benefits and limitations. Thai citizens with disabilities are eligible to receive primary dental care services, including preventive dentistry, fluoride therapy, dental prophylaxis, tooth extraction, tooth filling, and removable acrylic dentures 5 . However, the UHC plan includes out‐of‐pocket expenses for uncovered dental treatments such as root canal treatments and metal crowns.…”

“…There is considerable evidence that people with disabilities are in worse overall health and have poorer oral health than people without disabilities 2–4 . A prior study from Thailand reported that physical disabilities are related to insufficient oral hygiene practices among individuals with mobility impairments and hand function limitations 5 . Although these individuals can perform routine oral hygiene self‐care, they may experience specific problems during brushing teeth; for example, high muscle tone leading to unwanted movements, decreased balance control, and lack of concentration.…”

“…Poor oral hygiene and dental plaque accumulation are critical risk factors for periodontal diseases 4–7 . Gingivitis is a crucial pre‐requisite for periodontitis 8 .…”

“…A study from Spain has reported that persons with physical disabilities required specific assistance for improving gingival health status 22 . The oral health of Thai people with disabilities is affected not only by their disabilities and limited oral health literacy but also by physical and other barriers to accessing dental care services 5,23–25 . Consequently, normalizing daily oral hygiene is necessary to reduce gingivitis in these populations 6,26 …”

Ağız ve Diş Sağlığı Okuryazarlığı Nasıl ve Hangi Boyutlarda Ölçülüyor

“…TOFHLiD ölçüm aracı temel alınarak geliştirilen ölçüm araçları, okuma, okuduğunu anlama, sayısal beceri boyutunu ölçmektedir (17,23,37,38,44,48,53,55,56,59). HeLD ölçüm aracı temel alınarak geliştirilen ölçüm araçları okuyabilme, okuduğunu anlama ve sayısal beceri boyutlarını ölçmektedir (41,42,52,57). Araştırmalar içerisinde ADS bilgisi ya da kapsamlı ADSOY boyutunda ölçüm yapan araştırma sayısı sınırlıdır ve karar verme boyutunu içeren ölçüm aracı sayısı sekizdir.…”