Prevalence of and factors associated with fewer than 20 remaining teeth in Taiwanese adults with disabilities: a community-based cross-sectional study

Abstract

ObjectivesTo examine the prevalence of and the factors associated with a number of remaining teeth (NRT) <20 among adults with disabilities.DesignA community-based, cross-sectional descriptive study.SettingThis study was part of a health promotion programme designed for community-dwelling adults with disabilities.ParticipantsA total of 549 adults with disabilities, aged 20–80 years, living in the community in Chiayi County in Taiwan.Outcome measuresVarious parameters, including NRT, oral health behaviours (ie, oral hygiene, dietary habits and substance use), comorbidities, disability classification and capability for performing activities of daily living, were measured. Data were statistically analysed using descriptive statistics and multivariate logistic regression analysis.ResultsThe mean NRT was 18.1 (SD=10.9); 44.8% of participants had NRT <20 (including 13.7% edentulous participants). Most participants had poor oral hygiene: 83.4% reported seldom using dental floss, 78% did not undergo regular 6-monthly dental check-ups and 77.4% seldom brushed their teeth after meal. After adjusting for potentially confounding variables, the intellectual disability group had a significantly higher risk of an NRT <20 than the physical disability group (OR 2.30, 95% CI 1.30 to 4.08). Additionally, the rare use of dental floss and hypertension significantly increased the possibility of an NRT <20 (OR 1.73–2.12, 95% CI 1.15 to 3.71).ConclusionsAn NRT <20 and edentulism were highly prevalent among adults with disabilities, who displayed poor oral hygiene behaviours. Adults with intellectual disabilities had a greater likelihood of having an NRT <20 than did those with physical disability. In addition to unmodifiable factors, the poor use of dental floss was significantly associated with an NRT <20.

Characterization of oral health in a Portuguese population with mild intellectual disability

“…Our findings are similar to those obtained by Leroy and Declerck, for a population of 656 adults with various disabilities, in which 33% of the participants had 20 or less teeth . Note also that studies comparing individuals with physical disabilities and individuals with intellectual disabilities show that those with intellectual disabilities are more likely to have fewer teeth …”

“…Compared to other populations with disabilities, Liu et al 27 and Pradhan et al 28 found that 76.4% and 73% of the respondents, respectively, had not visited the dentist in the last year, similar to estimates for other disadvantaged groups, such as the homeless, 28 but considerably higher than those of our study, possibly due to differences in sample composition. Pan et al 29 also observed that 78% of the individuals with disability did not undergo regular appointments every 6 months, like our sample, in which 71.6% of the individuals had not visited the dentist in the last 6 months.…”

“…33 Note also that studies comparing individuals with physical disabilities and individuals with intellectual disabilities show that those with intellectual disabilities are more likely to have fewer teeth. 2,6,9,29,33 It should also be noted that authors of studies that use the DMF index for their clinical examination in patients with disability, affirm that the "decayed" and "missing" components contribute most to the high scores obtained, that tend to rise with an increase in the level of disability severity, especially in adults. 2,13 The least contributing factor is "filled teeth," again reflecting a worse provision of medical-dental care in individuals with intellectual disabilities, as well as the tendency to extract, rather than treat.…”

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

“…According to the WHO global disability action plan 2014-2021, there are approximately one billion disabled people globally (WHO, 2015). Existing studies report that people with disabilities have poorer oral health than people without disabilities (Chen et al, 2016;Pan et al, 2017;Rashid-Kandvani, Nicolau, & Bedos, 2015). These disabled people live in complex circumstances depending on the severity of their disabilities, including difficulty functioning, experiencing a combination of diseases (Dougall & Fiske, 2008a) and deficiencies in well-organized dental care services for people with special needs (Rashid-Kandvani et al, 2015;Sermsuti-Anuwat & Pongpanich, 2018a, 2018b.…”

“…With regard to the oral health of persons with physical disabilities, few studies have investigated the difficulties in accessing dental services (Chen et al, 2016;Leal Rocha et al, 2015;Rashid-Kandvani et al, 2015;Sermsuti-Anuwat & Pongpanich, 2018b). However, proper daily oral hygiene practices are necessary for persons with a permanent disability (Dougall & Fiske, 2008b;Kothari et al, 2017;Pan et al, 2017). There is limited evidence regarding the factors associated with periodontal diseases and oral hygiene status among independent, community-dwelling, adults with physical disabilities, who are capable of performing their own daily self-care.…”