Dental neglect: definition and prevention in the Louisiana Developmental Centers for patients with MRDD

When dental services and appropriate use of restraints are used for persons who are severely and profoundly mentally retarded and developmentally disabled (MRDD), oral health is enhanced and dental neglect is controlled or even reduced. This paper defines dental neglect and examines the consequences to persons who are MRDD when appropriate restraints and preventive dental home care are not used. Oral health outcome assessment data of this MRDD population indicate the presence or absence of dental neglect. The outcome assessment measures the level of oral health within the developmental center. The Louisiana Department of Health and Hospitals (DHH) operates nine developmental centers, where approximately 2000 individuals with severe to profound mental handicaps reside. Two-thirds (66%) of this population are resistive to the delivery of clinical and preventive dental services. The responsibilities and roles of dental health professionals, long-term-care facility administrators, and direct service staff are discussed to help reduce dental neglect in these centers. For these individuals to receive quality and comprehensive dental care, appropriate use of restraint/physical hold is necessary. The Dental Health Resource Program (DHRP) developed guidelines for delivering preventive and clinical dental services to reduce confusion and misinterpretation of the definition and use of restraint in the Louisiana Developmental Centers (LADCs).