Oral Health of Developmentally Disabled Adults: a Large Scale Study

Objectives:   This cross-sectional study investigated the oral health status of 4,732 adults with intellectual/developmental disabilities (I/DD) receiving dental care through a state-supported system of dental clinics.

Methods:   Data were collected from axiUm electronic health records of all adults aged 20 and older who received a dental exam between April 1, 2009 and March 31, 2010 and were eligible for services, insuring a diagnosis of I/DD. 

Results: The records of 4,732 I/DD adults met the inclusion criteria.  Fifty-seven percent were male, and their mean(SD) age was 49.25(14.21) years.  The majority (87.13%) allowed the placement of dental instrumentation intra-orally.  Overall, 511 (10.80%) were edentulous.  Edentulism increased with age, with 29.16% of the 60+ age group edentulous.  The mean(SD) numbers of decayed (D) teeth [1.06 (2.23)], missing (M) teeth [5.81(6.88)], filled (F) teeth [7.79(6.64)], and DMFT [14.66(9.69] were reported, along with the prevalence of untreated caries (37.65%) and periodontitis (79.89%). Each measure varied significantly with age. 

Conclusions: This large and heterogeneous group of adults with I/DD, despite having access to comprehensive dental care, demonstrated a significant burden of dental disease.  Management of oral health in this population presents significant challenges; age and ability to cooperate for dental care are important considerations.  The study population had a high prevalence of dental disease when compared to data from nationally representative samples.  Further research is required to identify and develop risk-based preventive interventions to manage oral disease for I/DD individuals and to maximize the role of dental professionals, patients and caregivers to maintain adequate oral health for I/DD individuals.