Gender differences in special needs populations

The August 2000 Surgeon General's report confirmed that neglected, vulnerable populations in the United States are not adequately receiving oral health services. The silent epidemic of dental and oral diseases in population groups such as persons with MRDD and the geriatric population results in a diminished quality of life. This article presents a study and research design intended to gather data and report the results as related to the needs of a population with MRDD. The Surgeon General stated that oral health issues in relation to gender have not been explored adequately. The data that were collected add information on health, [table: see text] disease, and health practices in a neglected population, helping in part to address this important concern. The analysis of study data statistically confirmed certain differences between women and men in this special needs population. Women and men experienced a similar number of filled surfaces and missing teeth. Reports of oral pain and daily tooth cleaning were also similar. The rates of fluorosis and the need for urgent treatment differed by gender, as did the number of persons missing a combination of anterior and posterior teeth. In this population men exhibited a greater frequency of past oral injury than women and a greater burden of untreated caries. Men also exhibited a greater frequency of gingival signs, indicating a possible lack of attention to proper oral hygiene; this finding was coupled with their greater frequency of need for urgent dental treatment. Although some reasons for these findings can be postulated, more research into the causes is warranted. Those findings can then form the basis for sound policy decisions that will improve the oral health of both men and women with special needs. Barriers to improved oral health, whether they result from problems with access to providers, from attitudinal problems inherent in the providers themselves, the patient, or the patient's caretakers, or from a possibly gender-biased database, must be effectively addressed. Such barriers can be removed through increased knowledge that takes into account any physiologic and psychosocial differences in men and women, particularly in the long-neglected segments of the population--the elderly and the developmentally disabled.