Article
Toothbrushing barriers for people with developmental disabilities: a pilot study
Christina J. Shin DDS,
Sophia Saeed DMD,
Christina J. Shin DDS
Harvard School of Dental Medicine, Pediatric Dentistry, Boston, Massachusetts, United States
Search for more papers by this authorCorresponding Author
Sophia Saeed DMD
University of California, San Francisco-School of Dentistry, Oral & Maxillofacial Surgery, 521 Parnassus Avenue, Box 0440 San Francisco, California, United States
Corresponding author e-mail: [email protected]Search for more papers by this authorChristina J. Shin DDS,
Sophia Saeed DMD,
Christina J. Shin DDS
Harvard School of Dental Medicine, Pediatric Dentistry, Boston, Massachusetts, United States
Search for more papers by this authorCorresponding Author
Sophia Saeed DMD
University of California, San Francisco-School of Dentistry, Oral & Maxillofacial Surgery, 521 Parnassus Avenue, Box 0440 San Francisco, California, United States
Corresponding author e-mail: [email protected]Search for more papers by this authorABSTRACT
Purpose
The aims of this study were: (1) to determine which step in tooth brushing is most difficult for individuals with developmental disabilities and (2) to determine if oral hygiene instruction improves technique.
Material and methods
Once per week for 6 weeks, disclosing solution was applied to the teeth of 14 subjects who were observed individually in their tooth brushing technique. Fourteen distinct steps were measured on a 4-point Likert scale. Plaque score was measured after brushing.
Results
The step causing greatest difficulty was “able to brush off residual, identified plaque.” Steps that showed greatest improvement were “open toothpaste” and “place toothpaste on brush.” The change in plaque score from the initial visit to the final visit was not statistically significant.
Conclusion
Oral hygiene instruction in a group and individual setting increased compliance in the initial steps of tooth brushing.
References
- 1 Closing the Gap: A national blueprint for improving the health of individuals with mental retardation. Report of the Surgeon General's Conference on Health Disparities and Mental Retardation. Rockville, MD: US Department of Health and Human Services; 2002.
- 2Burtner AP, Jones JS, McNeal DR, Low DW. A survey of the availability of dental services to developmentally disabled persons residing in the community. Spec Care Dent 1990; 10(6): 182-4.
- 3Dane JN. The Missouri Elks Mobile Dental Program – dental care for developmentally disabled persons. J Public Health Dent 1990; 50: 42-7.
- 4Davis JM. Issues in access to oral health care for special care patients. Dent Clin North Am 2009; 53(2): 169-81.
- 5Fenton SJ, Hood H, Holder M, et al.The American Academy of Developmental Medicine and Dentistry: eliminating health disparities for individuals with mental retardation and other developmental disabilities. J Dent Educ 2003; 67(12): 1337-43.
- 6Ferguson FS, Kamen P, Ratner S, Rosenthal R. Dental fellowships in developmental disabilities help broaden care of the disabled. NY State Dent J 1992; 58: 55-8.
- 7Glassman P, Miller CE, Lechowick J. A dental school's role in developing a rural, community-based, dental care delivery system for individuals with developmental disabilities. Spec Care Dent 1996; 16(5): 188-93.
- 8Glassman P, Miller C, Wozniak T, Jones C. A preventive dentistry training program for caretakers of persons residing in community residential facilities. Spec Care Dent 1994; 14(4): 137-43.
- 9Haden NK, Catalanotto FA, Alexander CJ, et al. Improving the oral health status of all Americans: roles and responsibilities of academic dental institutions. The report of the ADEA President's Commission. J Dent Educ 2003; 67(5): 563-83
- 10McDonald EP. Medical needs of severely developmentally disabled persons residing in the community. Am J Ment Defic 1985; 90: 171-6.
- 11Minihan PM, Dean DH. Meeting the needs for health services of persons with mental retardation living in the community. Am J Public Health 1990; 80: 43-8.
- 12 Policy Brief. Creating Adequate Sources of Oral Health Care for Low Income Persons with Disabilities on Medi-Cal. Statewide Task Force on Oral Health for People with Special Needs & Aging Californians.
- 13Preest M, Gelber S. Dental health and treatment of a group of physically handicapped adults. Community Health 1977; 9: 29-34.
- 14Schor EL, Smalky KA, Neff JM. Primary care of previously institutionalized retarded children. Pediatrics 1981; 67: 536-40.
- 15Waldman HB, Wong A, Perlman SP. Dental services for individuals with special health care needs are an increased reality for practitioners in California. J Calif Dent Assoc 2009; 37(6): 378-83.
- 16Waldman HB, Perlman SP. Mega numbers, lobbying and providing care for individuals with autism. Oklahoma Dental Assoc J 2009; 100(7): 16-20.
- 17Wilson KI. Treatment accessibility for physically and mentally handicapped people – a review of the literature. Community Dent Health 1992; 9: 187-92.
- 18Ziring PR, Kastner T, Friedman DL, et al. Provision of health care for persons with developmental disabilities living in the community. J Am Med Assoc 1988; 260: 1439-44.
- 19Scott A, March L, Stokes ML. A survey of oral health in a population of adults with developmental disabilities: comparison with a national oral health survey of the general population. Aust Dent J. 1998; 43(4): 257-61.
- 20 Guideline on Management of Dental Patients with Special Health Care Needs. American Academy of Pediatric Dentistry Council on Clinical Affairs. Pediatr Dent 2008–2009; 30(7 Suppl): 107-11.
- 21 Oral Health in America: A Report of the Surgeon General. Rockville, MD: US. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000.
- 22 The Disparity Cavity: filling America's oral health gap. Oral Health America; 2000.
- 23Haavio ML. Oral health care of the mentally retarded and other persons with disabilities in the Nordic countries: present situation and plans for the future. Spec Care Dentist 1995; 15: 65-9.
- 24Feldman CA, Giniger M, Sanders M, Saporito R, Zohn HK, Perlman SP. Special Olympics, Special Smiles: assessing the feasibility of epidemiologic data collection. J Am Dent Assoc 1997; 128: 1687-96.
- 25Waldman HB, Perlman SP, Swerdloff M. Use of pediatric dental services in the 1990s: some continuing difficulties. J Dent Child 2000; 67: 59-63.
- 26 Oral Health: Factors contributing to Low Use of Dental Services by Low-Income Populations. United States General Accounting Office. Report to Congressional Requesters. 2000.
- 27 National Institute for Dental and Craniofacial Research. Continuing Education: Practical Oral Care for People With Developmental Disabilities. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/ContinuingEducation.htm. Accessed May 13, 2012.
- 28Sanders C, Kleinert HL, Boyd SE, Herren C, Thiess L, Mink J. Virtual patient instruction for dental students: can it improve dental care access for persons with special needs? Spec Care Dentist 2008; 28(5): 205-13
- 29Waldman HB, Fenton SJ, Perlman SP, Cinotti DA. Preparing dental graduates to provide care to individuals with special needs. J Dent Educ 2005; 69(2): 249-54.
- 30Stiefel DJ. Dental care considerations for disabled adults. Spec Care Dent 2002; 22(3): 26S-39S.
- 31Bonito AJ. Executive summary: dental care considerations for vulnerable populations. Spec Care Dent 2002; 22(3): 5S-10S.
- 32Burtner P. University of Florida, College of Dentistry, Department of Pediatric Dentistry. Oral Health Care for Persons with Disabilities. Available at: http://www.dental.ufl.edu/faculty/pburtner/disabilities/. Accessed May 13, 2012.
- 33Cassamassimo PS, Seale NS, Ruehs K. General dentists’ perceptions of educational and treatment issues affection access to care for children with special health care needs. J Dent Educ 2004; 68(1): 23-8.
- 34Hallberg U, Klingberg G. Medical health care professionals’ assessments of oral health needs in children with disabilities: a qualitative study. Eur J Oral Sci 2005; 113: 363-8
- 35Rhodus NL. Oral health and systemic health. Minn Med 2005; 88(8): 46-8.
- 36Lewis D, Fiske J, Dougall A. Access to special care dentistry, part 8: seamless care, part 2. Brit Dent J 2008; 205(6): 305-17.
- 37Waldman HB, Perlman SP. Disability and rehabilitation: do we ever think about needed dental care? A case study: the USA. Disabil Rehabil 2010; 32(11): 947-51.
- 38Glassman P, Miller C. Dental disease prevention and people with special needs. J Cal Dent Assoc 2003; 31(2): 149-60.
- 39Dougall A, Fiske J. Access to special care dentistry, part 4. Education. Brit Dent J 2008; 205(3): 119-30.
- 40Thornton JB, al-Zahid S, Campbell V, Marchetti A, Bradley ELJr. Oral hygiene levels and periodontal disease prevalence among residents with mental retardation at various residential settings. Spec Care Dent 1998; 9(6): 186-90.
10.1111/j.1754-4505.1989.tb01185.x Google Scholar
- 41 A Brief History of DD in the United States. Office of Developmental Primary Care. San Francisco: University of California. Available at: http://developmentalmedicine.ucsf.edu/odpc/. Accessed May 13, 2012.
- 42 A Consensus Statement on Health Care Transitions for Young Adults With Special Health Care Needs. American Academy of Pediatrics, American Academy of Family Physicians and American College of Physicians-American Society of Internal Medicine. Pediatrics 2002; 110; 1304-1306.
- 43Green JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc 1964; 68: 7-13.
Citing Literature
