Access to dental care among adults with physical and intellectual disabilities: residence factors

© 2009 Australian Dental AssociationBackgroundThere is limited information about access and barriers to dental care among adults with disabilities.MethodsA mailed questionnaire survey of carers of 18-44-year-old South Australians with physical and intellectual disabilities (care recipients; n = 485) in family homes, community housing and institutions. Bivariate associations were tested using chi-square tests. Odds ratios (ORs) and 95 per cent confidence intervals (CI) were estimated for irregular dental visits (IDV).ResultsCarers from family homes and community housing were more likely to report problems in obtaining dental care than those at institutions (p ConclusionsCare recipients in institutions and community housing had better access to dental care than those at family homes. The shortage of dentists in SND and treatment costs needs to be addressed.A Pradhan, G.D. Slade, A.J. Spence

Factors influencing caries experience among adults with physical and intellectual disabilities

BackgroundThere is limited and inconsistent evidence on the influence of residential setting on caries experience of adults with physical and intellectual disabilities (PID), described here as care-recipients.ObjectiveTo examine caries experience and associated factors among adults with PID.MethodsMailed questionnaire survey (2005-2006) of carers of adults with PID (18-44 years) in South Australia from family homes, community housing, and institutions, and oral examinations of care-recipients recording decayed (D), missing (M) and filled (F) teeth (DMFT).ResultsCarers completed questionnaires for 485 care-recipients, 267 of whom were examined (completion rate=55.1%). The prevalence of decay (D>0) was 16.9% and 76.3% had caries experience (DMFT>0). In unadjusted analysis, care-recipients at institutions had a significantly higher mean DMFT than other settings. After adjusting for carer and care-recipient characteristics, there was no difference in any of the DMFT components among residential settings. However, there were statistically significant associations (OR+/-95% CI excluding unity) between decayed teeth and moderate and high intake of sweet drinks and frequency of dental visits. Higher odds of missing teeth were associated with type of disability, general anaesthetic requirement for dental treatment and low and high carer-contact. Higher odds of filled teeth were associated with age, no oral hygiene assistance (OHA) and high carer-contact. Higher odds of caries experience were associated with age and no OHA.ConclusionsResidential setting was not associated with caries experience. Modifiable risk factors were diet, frequency of dental visits, no OHA and carer-contact hours.Archana Pradhan, Gary D. Slade and A. John Spence

Review of the evidence for oral health promotion effectiveness

Dental caries, periodontal diseases, tooth loss and oral cancers have significant burden of disease effects *, quality of life and cost implications for the Australian community. Oral health promotion is a key approach to addressing these conditions endorsed as part of the National Oral Health Plan. Understanding the evidence for effectiveness of oral health promotion is integral to strategic planning for both oral and general health settings. Objective: The objective of this article is to report the key findings of a systematic review of the evidence for oral health promotion commissioned by the Victorian Department of Human Services in 2006. Methods: Evidence was collected and evaluated using a combined approach incorporating the Cochrane Public Health and Health Promotion Field Handbook and the Health Gains Notation in order to a develop a synthesis approach to reporting, framed around the Ottawa Charter. Findings: Findings included evidence supporting the continued fluoridation of water supplies, interventions aimed at early childhood and aged care settings, smoking cessation and capacity building with non-oral health care providers. Emerging evidence supporting multi-strategy community based approaches is also reported along with gaps in the evidence. General Conclusions: The authors conclude that, while there is good support for the incorporation of oral health into general health promotion, it will be important to monitor the outcomes in oral health terms