Oral health of adults with intellectual disabilities: a systematic review

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.

Oral Health Awareness and Practices of Special Needs Caregivers in Qatif, Saudi Arabia

“…In line with earlier studies, the need to maintain proper oral health care is critical to ensure optimal health outcomes (4)(5)(6)(7)(8)(9)(10)(11). In Saudi Arabia, poor oral hygiene is a growing concern across the population strata, especially preventive behaviors that primarily depend on caregiver awareness and attitudes toward oral health preven-tive measures and practices (12,32,33).…”

“…Dental care for individuals with disabilities requires specialized knowledge and skills in addition to heightened community awareness of proper oral health practices (2). Studies show that individuals with special health needs are more vulnerable to oral diseases throughout their life (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Compromised oral health often leads to serious health issues, which can significantly affect the individual quality of life.…”

Restoration of an Upper Anterior Tooth in an Adolescent with Autism Spectrum Disorder—A Student Case Report

“…Both of these factors, however, strongly depend on the quality of care and support provided in patients' homes. Unfortunately, as was observed in a number of studies from different countries, this type of care generally still needs to be improved, in light of the fact that the oral health status of persons with intellectual disability, or children attending special needs schools because of various disabilities, was, on average, shown to be poorer than that of persons of the same age in the general population [51,52].…”

What is it about carer‐led oral hygiene interventions for people with intellectual disabilities that work and why? A realist review

“…For people with intellectual disability, oral hygiene is consistently poor, periodontal disease is often more severe and extensive compared to the general population, and dental caries is often untreated or treated by extraction. 2,3 Dental pain often presents behaviourally and may be undiagnosed. 4,5 In response to the disparities in oral health between people with intellectual disabilities and the general population, many have tried to improve the oral hygiene of people with intellectual disabilities.…”