How do intellectual disabilities affect oral health?

Area of Science:

• Oral Health Research
• Public Health
• Disability Studies

Background:

• Adults with intellectual disabilities (ID) often face significant barriers to accessing adequate oral healthcare.
• Existing literature highlights persistent oral health disparities in this vulnerable population.

Purpose of the Study:

• To systematically review and synthesize evidence on the oral health status of adults with ID.
• To identify the prevalence of oral diseases and unmet dental needs in adults with ID.
• To evaluate the impact of care provision and identify areas for improvement.

Main Methods:

• A systematic review of studies published between 2008 and 2018, following previous reviews up to 2008.
• Searches conducted across major databases: PubMed (MEDLINE), Web of Knowledge/Science (WoK/WoS), PsycINFO, and EMBASE.
• Data extraction and quality assessment using the Oxford Critical Appraisal Skills Programme (CASP) Checklist, with dual reviewer checks.

Main Results:

• Thirty-three studies were included, with 17 deemed strong quality.
• High prevalence of decayed teeth, untreated decay, and high DMFT scores were reported.
• Poor oral hygiene, gingival health, and significant rates of periodontitis (22.5%-69.2%) were consistently observed.
• Adults with ID experienced higher edentulism rates and poorer oral health in institutional settings.

Conclusions:

• Adults with ID continue to experience poor oral health and substantial unmet dental needs, despite care improvements.
• Confounding factors like manual dexterity and comorbidities were often under-addressed in studies.
• Recommendations include enhancing access to dental services and specialized training for dental practitioners to reduce oral health inequalities.