Tooth decay more common among disabled

TOOTH decay, including loss of all natural teeth, is far more common in adults with intellectual disability than among the general population.

The first national oral health survey of adults with an intellectual disability in residential care found 61% aged 55+ years have no natural teeth compared to 41% of adults aged 65+ years in the general population.

Twenty percent of the 35 to 54-year-old age group were found to have oral lesions (diseased tissue). Three percent of this age group were found to have suspect oral cancerous lesions that required urgent referral for further review.

It also found adults with an intellectual disability who are missing all their own natural teeth do not wear dentures and have been assessed by the dentists as not being suitable for dentures.

“The impact of this on their quality of life is unknown but must be profound,” the authors of the survey said.

The vast majority of adults examined as part of the study had gingivitis, the severity of which increased with age.

Coordinated by the Oral Health Services Research Centre, University College Cork, the report recommends early and regular dental screening of groups with special needs.

“This would allow for the early detection of disease so that other treatment options other than extraction could be considered.

“In addition, assumptions regarding the suitability for denture wearing and ability to benefit from dental treatment need to be explored and tested,” the report said.

The survey, designed to be of assistance to policymakers and service providers in the planning of services for the intellectually disabled was carried out in 2003 and involved 10 teams of trained and calibrated dentists and dental nurses examining 281 adults in 27 units in Ireland.

It found the majority of residents have been in residential care for more than 10 years and do receive regular dental treatment or check ups; however while some health boards report having relatively good services, others reported minimal care.

“Although the majority of units did not perceive access to dental services as a problem, this client group has a large amount of unmet dental treatment need.

“Overall at least 50% of the adults examined required some kind of dental treatment,” the report warned.

It found the majority of residents need help to maintain adequate oral and denture hygiene, yet only 12% of units had written guidelines on how to provide oral healthcare for clients.