Oral health


Poor oral health in adults with intellectual disabilities and its determinants: Secondary analysis of linked administrative and health records

 

Background

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.

Aims

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. 

Methods

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