Assessment & Research

Cross-sectional study of the factors associated with the number of teeth in middle-aged and older persons with intellectual disabilities.

Nonoyama et al. (2022) · Journal of intellectual disability research : JIDR 2022
★ The Verdict

Adults with Down syndrome and spotty dental visits lose the most teeth, so lock in regular cleanings.

✓ Read this if BCBAs working with adults or teens with ID in residential or day programs.
✗ Skip if Clinicians who only serve typically developing children.

01Research in Context

01

What this study did

Lee et al. (2022) counted teeth in adults with intellectual disability. They looked at age, diagnosis, and dental visit history.

The team used a snapshot design. One visit gave each person’s age, diagnosis, and tooth count.

02

What they found

Older adults had fewer teeth. Adults with Down syndrome had the biggest tooth loss. Adults who skipped regular dental visits also had more missing teeth.

Adults with autism kept slightly more teeth than peers with other diagnoses.

03

How this fits with other research

Li et al. (2015) saw the opposite in preschoolers. Their autistic 3- to 5-year-olds had less decay and healthier gums than typical kids. Age explains the flip: baby teeth versus adult teeth.

Gandhi et al. (2022) and Corridore et al. (2026) show how to fix access problems. Sensory-adapted rooms and short pre-visit lessons triple dental success for autistic children. T et al. say adults need the same routine access.

de Moraes et al. (2013) set the baseline. They proved dental X-rays age kids with Down syndrome just as well as typical kids. T et al. now show what happens when those kids become adults without steady care.

04

Why it matters

If you serve adults with ID, schedule dental exams every six months. Put Down syndrome and older adults at the top of the list. Use the same sensory tricks that work for kids: dim lights, quiet tools, and a social story before the chair reclines. A standing appointment prevents tooth loss better than any crisis visit.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add a dental check-up to the next ISP review for every adult with Down syndrome.

02At a glance

Intervention
not applicable
Design
other
Sample size
604
Population
intellectual disability, autism spectrum disorder, down syndrome
Finding
not reported

03Original abstract

BACKGROUND: We investigated the number of teeth in middle-aged and older individuals with intellectual disability and evaluated the related factors. METHODS: A questionnaire survey on oral health was administered to 604 persons over 40 years old with intellectual disabilities in Aichi Prefecture, Japan. The questionnaire designed for this study included items on diagnosis of disability, severity of intellectual disability and type of residence. As oral-health-related factors, the proxy-reported number of teeth, family dentist, regular dental check-ups, problems during dental treatment and tooth-brushing frequency were evaluated. A multinomial logistic regression analysis was performed using the proxy-reported number of teeth (≥20, 10-19 or 0-9) as the dependent variable, and the odds ratios (ORs) and 95% confidence intervals (CIs) of independent variables were calculated. In addition, linear regression analysis was performed using the proxy-reported number of teeth as the dependent variable. RESULTS: In the multivariate multinomial logistic regression analysis, age, diagnosis of disability and type of residence were significantly associated with having 10-19 versus ≥20 teeth. Participants with autism spectrum disorder had a significantly lower OR for 10-19 teeth compared with those with intellectual disability [OR (95% CI): 0.49 (0.22-1.08)]. Age, diagnosis of disability, regular dental check-ups and tooth-brushing frequency were significantly associated with having 0-9 versus ≥20teeth. Participants with Down syndrome had a significantly higher OR for 0-9 teeth compared with those with intellectual disability [OR (95% CI): 3.17 (1.09-9.23)]. The ORs for 0-9 teeth of participants who did not attend regular dental check-ups and who brushed their teeth 1 time/day compared with ≥3 times/day were significantly high, and the OR (95% CI) was 2.37 (1.06-5.30) and 4.76 (1.09-20.77), respectively. [Corrections made on 22 August 2022, after first online publication: in the previous sentence, "who attend" has been changed to "who did not attend".] In the multivariate linear regression analysis, age, diagnosis of disability and regular dental check-ups were significantly associated with the proxy-reported number of teeth. The proxy-reported number of teeth was -0.42 less with each 1-year increase in age. With autism spectrum disorder, the proxy-reported number of teeth was 0.74 more compared with intellectual disability. In Down syndrome, the proxy-reported number of teeth was -0.93 less compared with intellectual disability. The proxy-reported number of teeth was -2.12 less for those who did not have regular dental check-ups. CONCLUSIONS: The number of teeth in middle-aged and older individuals with intellectual disability was related to age and the type of disability. Regular dental visits may be effective at preventing tooth loss in middle-aged and older persons with intellectual disability.

Journal of intellectual disability research : JIDR, 2022 · doi:10.1177/2380084420981016