Poor oral health in adults with intellectual disabilities and its determinants
Adults with intellectual disabilities experience extensive health inequalities compared with the general population. There is some evidence suggesting that they also have greater dental treatment needs. They may experience poor oral health because of conditions linked with dental disease (e.g. diabetes), use of certain medications (e.g. antipsychotics) and poor dental hygiene. Oral health influences psychological wellbeing and satisfaction in the general population, and there is no reason to suggest that this is any different for people with intellectual disabilities. We investigated the prevalence and determinants of poor oral health in adults with intellectual disabilities.
The adult population (aged 16 years and over) of people with intellectual disabilities living within the geographical area of Greater Glasgow Health Board, Scotland, were identified and recruited. Each participant underwent a dental examination. Data analysis generated descriptive statistics about the oral health of people with intellectual disabilities and determinants of poor oral health.
579 adults with intellectual disabilities took part twice, in 2002-2004 and 2004-2005. 309 (53.4 %) males and 270 (46.6%) females aged 46 years (18-81). 31% were edentulous. Further analysis will be presented.
Using a robust study design in a large population, we reported the high prevalence of poor oral health in this population and its determinants.
For further information on this project, please contact Deborah Kinnear
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Poor oral health in adults with intellectual disabilities and its determinants: Secondary analysis of linked administrative and health records
Oral health care is a fundamental part of personal care, and a priority for the World Health Organisation and Scottish Government. Dental problems have important consequences for general nutrition, communication, self-confidence, and participation in society, and impact on psychological wellbeing and satisfaction. Adults with intellectual disabilities experience extensive health inequalities, yet their oral health has largely been overlooked. There is some evidence suggesting they have greater dental needs, but these studies have methodological limitations. Adults with intellectual disabilities may have poor oral health due to over-prescription of medications with anticholinergic burden, particularly psychotropics (which can cause xerostomia, contributing to tooth decay and loss) and sugared liquid medicines, poor diet, and poor dental hygiene. There is also a relationship between poor oral health and some systemic diseases in the general population, which may also be important for people with intellectual disabilities as several occur more commonly. Despite these major, and importantly, potentially preventable problems, there has been surprisingly little attention paid to oral health and its determinants in intellectual disabilities support services, and little awareness amongst clinicians and prescribers specialising in working with adults with intellectual disabilities.
The aims of this study are to: (i) identify the extent of poor oral health (dental extractions, restorations, and other treatments) and attendance for preventative dental check-ups in about 4,000 population-based adults with intellectual disabilities which will be compared with the general population; (ii) identify the determinants of poor oral health in people with intellectual disabilities, focussing on extent of use of medications with anticholinergic burden and sugared liquid medicines, long-term conditions which may be related to poor oral health, and preventative dental care.
Data linkage and secondary data analysis of routinely collected primary and secondary care dental and health administrative data: NHS Greater Glasgow and Clyde Primary Care Intellectual Disabilities Register (already linked to primary care long-term conditions data), Management Information & Dental Accounting System (MIDAS), R4 Dental Records System, Scottish Morbidity Records (SMR01), and Prescribing Information System (PIS).
Implications for Policy and Practice
The proposed study addresses important and overdue questions on oral health, and will raise awareness which should help to reduce the future suffering of people with intellectual disabilities.
For more information on this project, please contact Deborah Kinnear