Oral Health Promotion among Individuals with Intellectual Disabilities: A Systematic Review.

People with disabilities experience inferior health and poor access to good quality health services as compared with the general population. Optimum oral health is associated with improvement in the quality of life in such patients. As oral diseases are largely preventable, good oral health education can have a positive impact on individuals with disabilities. So, the aim of the study was to review the effectiveness of oral health promotion among individuals with intellectual disabilities (IDs). Seven electronic databases were searched using keywords like intellectual disability/mental retardation/learning disability AND dental health education/health promotion. All records that were identified electronically from this search were subjected to a preliminary review to identify eligible papers. Identified studies were grouped into oral health promotion directed at individuals with IDs, and those aimed at caregivers of people with IDs. Interpretation of the outcomes included the effects on oral health knowledge, attitudes, and behaviors (either observed or self-reported). Eventually, 16 studies were included in the review including five studies that were randomized controlled trials, while the remaining 11 studies were pre-post single group oral health promotion studies. Critical appraisal of each study was conducted with the 21-item criteria by Kay and Locker (1997) to provide a numerical quantification and ranking of the evidence. Positive changes in the behaviors and attitudes were observed, while other studies reported a considerable improvement in the knowledge of caregivers for oral healthcare of individuals with IDs. However, such activities need to be done over a long period of time with constant monitoring.

The Effect of Usage of Antiasthmatic Inhalers on Color Stability and Surface Roughness of Dental Restorative Materials: An In Vitro Study.

OBJECTIVES: Increased demand for esthetics by parents and children has resulted in the use of tooth-colored restorative materials. Children with chronic respiratory conditions like asthma use inhalers which have shown to affect the surface of restorative materials. Hence, the aim of the present study was to evaluate the effect of antiasthmatic inhalers on color stability and surface roughness of three restorative materials. MATERIALS AND METHODS: Forty samples each of three dental restorative materials: group A: glass ionomer cement (GIC), group B: alkasite restorative material, and group C: composite resins were prepared. Each group was further divided into two subgroups of 20 samples each according to the inhaler used. All the specimens were polished using polishing discs and stored in artificial saliva in order to simulate the oral environment. The baseline color value and surface roughness of all the samples were measured using a spectrophotometer and a profilometer, respectively. Group 1 and group 2 were exposed to 0.31 mg of salbutamol sulfate and 20 mg formoterol fumarate in combination with budesonide, respectively, for every 12 hours, for a period of 15 days following which the samples were evaluated for color changes and surface roughness. STATISTICAL ANALYSIS: The data obtained was subjected to statistical analysis and level of significance was set at p < 0.05. RESULTS: Exposure to both the inhalers caused a change in color and surface roughness in all three restorative materials. There was a significant change in the color of GIC and composite resin (ΔE > 3.3), following exposure to both the inhalers (p < 0.05). The change in color of alkasite restorative material was not significant. A significant increase in the surface roughness of composite resin from 0.56 ± 0.14 to 0.67 ± 0.19 was seen following 15 days' exposure to formoterol in combination with budesonide inhaler (p < 0.05). CONCLUSION: Following exposure, both the inhalers had an equal effect on color and surface roughness of all three restorative materials. Alkasite restorative material showed greater resistance to change in color and surface roughness when exposed to antiasthmatic inhalers, compared to GIC and composite resin. Thus, children who use inhalers and nebulizers should be advised to implement more precautionary oral hygiene measures and periodic dental visits.

Satisfaction of Oral Health Education among Parents and Caregivers Regarding Children with Special Healthcare Needs in Riyadh, Saudi Arabia.

AIM AND OBJECTIVE: The aim of the study was to evaluate the satisfaction of an oral health promotion program among parents and caregivers of children with special healthcare needs (CSHCN) in Riyadh, Saudi Arabia. MATERIALS AND METHODS: A digital survey using Google forms was used during an event to commemorate the World Disability Day. Stalls for oral health education and training were set up at Disabled Children Society, Riyadh, Saudi Arabia. Oral health education was carried out using written pamphlets, brochures, and videos. Live demonstration on dental models was used for tooth-brushing training using a powered toothbrush. Parents and caregivers were asked to complete a survey about oral health education during the event. An overall 189 parents and caregivers of CSHCN including 62 males and 127 females completed the survey. The responses were entered digitally prior to being evaluated. RESULTS: The respondents were parents and/or caregivers of children mostly having cerebral palsy followed by autism. Females consisted of 67% of the respondents. Eight-one percent of respondents rated it as highly satisfied. Ninety-one percent of the respondents perceived that the information provided was new for them regarding oral healthcare for CSHCN. Ninety-eight percent of respondents were likely to attend a similar event in the future. CONCLUSION: Majority of parents and caregivers of CSHCN were highly satisfied by the oral health education during the event. They felt that they can take better care of the oral health of their CSHCN after the oral health education and training. CLINICAL SIGNIFICANCE: Oral health among CSHCN is neglected when compared to children among the general population. CSHCN exhibit many barriers to oral health care. Oral health promotion among CSHCN is important as they have a high unmet oral health need.

Oral health knowledge and attitude among caregivers of special needs patients at a Comprehensive Rehabilitation Centre: an analytical study.

AIM: To evaluate knowledge and attitude of caregivers/healthcare workers regarding oral health of special need patients, at a comprehensive rehabilitation centre. MATERIAL AND METHODS: A validated self-administered structured questionnaire was used in an interview style among 120 caregivers at a comprehensive rehabilitation centre. The first part of questionnaire collected demographic information (age, gender, experience, literacy). The other part of the questionnaire was related to the knowledge and attitude of caregivers regarding importance of oral health including oral hygiene practices, cause of tooth decay, significance of fluoride, common oral problems and need for oral health education. Comparison between oral health knowledge and oral health attitude of caregivers was done using one-sample t Test. The level of significance was set as p=0.005*. RESULTS: Adequate oral health knowledge was found to be among 59.2% and favourable attitude of caregivers towards oral health care was found among 48.3%. The results indicate that though majority among caregivers had adequate knowledge but their attitude towards oral health was inadequate. CONCLUSION: Caregivers showed a deficiency in the proper oral health attitude. To improve oral health attitudes of caregivers, dental education plus training programs should be given high priority.

Antibacterial Activity of Two Chemomechanical Caries Removal Gels on Carious Dentin of Primary Teeth: An in vitro Study.

INTRODUCTION: Chemomechanical caries removal (CMCR) is an effective method of caries removal especially for primary teeth as they cause less discomfort when compared with conventional caries removal. The most significant thing about caries removal is the elimination of cariogenic bacteria. This study compares the antibacterial activity of two CMCR gels. MATERIALS AND METHODS: A total of 40 primary molar teeth with carious dentin were split along the long axis in a laboratory. Total viable count (TVC) was taken for the teeth before splitting as a measure of colony-forming units per milliliter (CFU/mL). Each half was treated with either Carisolv or Carie-Care CMCR gels. Clean dentin samples were evaluated for Streptococcus mutans (SM) and Lactobacillus acidophilus (LB) after removal of carious tissue using the caries removal gels using serial dilutions and incubating on specific agar plates. RESULTS: The results showed significant reduction in mean TVC after use of both the CMCR gels. Both gels reduced the CFU/mL of SM and LB to a significant level (p < 0.05). However, there was no significant difference between the antibacterial activities of the two CMCR gels. CONCLUSION: The CMCR gels (Carisolv and Carie-Care) significantly reduced the residual TVC as well as SM and LB in carious primary dentin. Both CMCR gels had a similar antibacterial activity on the carious dentin of primary teeth. CLINICAL SIGNIFICANCE: The CMCR gels tested have a significant antibacterial activity and can be effectively used for elimination of caries-causing bacteria in primary teeth.

Access to oral health care services among adults with learning disabilities: a scoping review.

BACKGROUND: The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. OBJECTIVES: The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. METHODS: Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. RESULTS: Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. CONCLUSIONS: The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.