Systematic literature review of oral health in adults with learning disabilities

Oral Health | Last Updated: 20 Apr 26

Background

There have been previous reports of adults with learning disabilities experiencing poor oral health, in terms of tooth loss, periodontal (gum) health and untreated dental caries (decay). However, in recent years, social care provision has changed, with deinstitutionalisation and home-based personalised care now being the typical provision in high income countries. Therefore we aimed to critically review and synthesise recent world-wide evidence relating to adults with learning disabilities and oral health.

What we did

The review was registered with the International Prospective Register of Systematic Reviews (Prospero), registration number CRD42018089880. Four databases were searched (EMBASE, MEDLINE, PsychINFO, WoS) from 2008-2018 with a clear search strategy. We used a strict inclusion criteria for selection of papers, double scoring (two raters), systematic data extraction and quality appraisal for included papers.

What we found

A total of 33 out of 3 958 articles were included, of which 14 were from dental service users and 10 from the Special Olympics programmes, therefore not necessarily representative of the population with learning disabilities. Poor gum health (gingivitis) was frequently reported with ranges from 23-69% prevalence. The more severe disease – periodontitis, was reported with ranges of 23-69% prevalence. There was evidence of poor oral hygiene and untreated dental decay (caries).

What these findings mean

There is a clear unmet need relating to both gum and tooth health, leading to tooth loss. Despite previous reports of poor oral health and despite this being preventable, there remains a high burden of poor oral health in adults with learning disabilities. The importance of oral health and its possible negative sequelae needs to be elevated amongst carers and professionals. Furthermore, findings highlight the need for further robust quality research to explore the oral health needs of a representative sample of adults with learning disabilities.

Project lead: Laura Ward

Research team: S. A. Cooper, L. Hughes-McCormack, L. Macpherson, D. Kinnear

Project information last updated September 2020.

SLDO Group member(s) involved in this research

Dr Laura Ward

Laura is an Affiliate Associate Researcher at the Observatory, involved in ongoing work about cancer screening, cancer incidence and cancer-related deaths, as well as pain and prescribing in adults with intellectual disabilities/autism. In 2023, Laura took up the role of Project Manager of the Trusted Research Environment (TRE) at the Health Informatics Centre (HIC) at the University of Dundee. The TRE, or Safe Haven as it is known in Scotland, is responsible for curation and provisioning of NHS Scotland patient data.

Professor Deborah Cairns

Deborah is the Director of the Scottish Learning Disabilities Observatory and Professor of Health and Neurodevelopmental Conditions, in the School of Health and Wellbeing, at the University of Glasgow. Deborah is passionate about her research which aims to improve the health of people with learning disabilities and their families. She has worked on many different projects about people with learning disabilities including: cancer incidence, cancer screening, multi-morbidity (having two or more health conditions), oral health and COVID-19, to name a few. She has also worked on projects about the physical and mental health of family members who support someone with a learning disability. Deborah is committed to conducting research that has impact and works closely with self-advocates with learning disabilities, family carers and third sector organisations who are pivotal in all of her work and who have a shared vision of ensuring the human rights of all people with learning disabilities are recognised, supported and upheld.

Professor Anna Cooper

Anna set up the Scottish Learning Disabilities Observatory with funding from the Scottish Government. She wants the Observatory to make Scotland fairer and healthier for people with learning disabilities and their families, by: Finding out the health problems people have Finding out how good or bad health care is Telling people about health and health care problems Finding ways to make health and health care better Checking if health gets better or worse over time Helping the Scottish Government, and staff who provide health and social services, to get it right for people with learning disabilities Anna is a doctor. She has done a lot of studies on the health of people with learning disabilities. Anna’s full name is Professor Sally-Ann Cooper.

17 128 Laura Hughes Mccormack 001 staff image

Dr Laura Hughes

Laura is a Lecturer in Clinical Psychology at the University of Glasgow, and an affiliate of the Scottish Learning Disabilities Observatory, having joined the team in 2015. With the Observatory, Laura was involved in projects looking at the health of people with learning disabilities in a number of large data-sets, including primary health care records, Scotland's 2011 Census and health records of people born with Down Syndrome in Scotland over a 25 year period. Laura studied Psychology and has extensive experience of working with people with learning disabilities in her previous roles, for example, as a Befriender, a Learning Assistant and an Assistant Psychologist. Read more about Laura at the link below