Oral Health Promotion among Individuals with Intellectual Disabilities: A Systematic Review

Abstract

People with disabilities experience inferior health and poor access to good quality health services as compared with the general population. Optimum oral health is associated with improvement in the quality of life in such patients. As oral diseases are largely preventable, good oral health education can have a positive impact on individuals with disabilities. So, the aim of the study was to review the effectiveness of oral health promotion among individuals with intellectual disabilities (IDs). Seven electronic databases were searched using keywords like intellectual disability/mental retardation/learning disability AND dental health education/health promotion. All records that were identified electronically from this search were subjected to a preliminary review to identify eligible papers. Identified studies were grouped into oral health promotion directed at individuals with IDs, and those aimed at caregivers of people with IDs. Interpretation of the outcomes included the effects on oral health knowledge, attitudes, and behaviors (either observed or self-reported). Eventually, 16 studies were included in the review including five studies that were randomized controlled trials, while the remaining 11 studies were pre-post single group oral health promotion studies. Critical appraisal of each study was conducted with the 21-item criteria by Kay and Locker (1997) to provide a numerical quantification and ranking of the evidence. Positive changes in the behaviors and attitudes were observed, while other studies reported a considerable improvement in the knowledge of caregivers for oral healthcare of individuals with IDs. However, such activities need to be done over a long period of time with constant monitoring.

The Public Health Approach to Oral Health: A Literature Review

“…Within the group-level, we included community-based, senior-citizen-centre-based, school-based, population-based, and workplace-based strategies. Here, the majority of articles fell into the community-based strategies [13][14][15][16][17][18], followed by school-based strategies [19][20][21]. At the individual-level, we identified two strategies: behavioural change interventions [22] and general OH promotion [23][24][25][26].…”

“…Within education and awareness, identified components were OH education, OH behaviour change motivation, behaviour guidance, and OH advocacy. The majority of articles had some component of OH education in their strategies [13,14,[16][17][18][19][20][21][22][23][25][26][27][31][32][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49], followed by a component related to OH behaviour change motivation [18- We then analysed the data to identify the main components of said strategies and grouped them in clusters based on their thematic similarities-focusing on educational, service-related, intervention, and policy aspects of OH. There were four clusters: (1) education and awareness, (2) OH services and access, (3) interventions and treatments, and (4) policy, environment, and population health.…”

“…Within education and awareness, identified components were OH education, OH behaviour change motivation, behaviour guidance, and OH advocacy. The majority of articles had some component of OH education in their strategies [13,14,[16][17][18][19][20][21][22][23][25][26][27][31][32][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49], followed by a component related to OH behaviour change motivation [18][19][20][21][22]31,33,34]. OH education was most commonly found in articles that cited strategies using non-dental health workers [31][32][33][34][35]37,38] and community-based strategies [13,14,…”

“…Although having been used as a strategy, teledentistry was also included as a component due to its use in an integrated OH intervention. Within this cluster, chemical interventions were the most prevalent [15,17,23,24,48], followed by mechanical interventions [13,23,24,47]. The final cluster, policy, environment, and population health, included the following components: OH policies, food environment, population health, and evidence-informed OH.…”

“…Strategies focusing on maternal and/or child health were dividing between population-based [48], general OH promotion [25], non-dental health workers [31,38], and teledentistry [43]. Regarding individuals with developmental disabilities, two articles involved general OH promotion [23,24], and one was community-based [13]. As for older adults, strategies were divided between senior-citizencentre-based strategies [47], devising OH policies [27], and teledentistry [42].…”