Dental attendance, restoration and extractions in adults with intellectual disabilities compared with the general population: a record linkage study.
Adults with ID see dentists often yet receive fewer fillings, hinting dentists choose extractions over restorations.
01Research in Context
What this study did
The team looked at dental records for adults with intellectual disability. They matched each adult to a similar adult without disability.
They counted how often each person saw a dentist. They also counted fillings and tooth removals.
What they found
Adults with ID went to the dentist more often. Yet they got fewer fillings and only slightly fewer extractions.
The pattern changed with age. Older adults with ID had the biggest gap in fillings.
How this fits with other research
Kancherla et al. (2013) saw the opposite: young adults with ID visited less often. The two studies look different, but they studied different age groups. Young adults may skip care until pain hits. Adults already in the system keep appointments.
Koegel et al. (2014) found adults with IDD had lower emergency dental visits. Heald et al. (2020) now show they attend routine care more. Together the papers say: adults with ID use planned visits, not the ER, yet still end up with fewer fillings.
Mammarella et al. (2022) proved brief behavioral training lets many adults with IDD get a real exam without sedation. Their work gives you a tool to turn high attendance into high-quality care.
Why it matters
High attendance but low fillings signals dentists may pull teeth instead of fixing them. You can advocate for preventive plans before decay starts. Add a dental desensitization program like Mammarella et al. (2022) so your clients can tolerate longer restorative visits. Track fillings, not just visits, in your outcome reports.
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02At a glance
03Original abstract
BACKGROUND: Oral health may be poorer in adults with intellectual disabilities (IDs) who rely on carer support and medications with increased dental risks. METHODS: Record linkage study of dental outcomes, and associations with anticholinergic (e.g. antipsychotics) and sugar-containing liquid medication, in adults with IDs compared with age-sex-neighbourhood deprivation-matched general population controls. RESULTS: A total of 2933/4305 (68.1%) with IDs and 7761/12 915 (60.1%) without IDs attended dental care: odds ratio (OR) = 1.42 [1.32, 1.53]; 1359 (31.6%) with IDs versus 5233 (40.5%) without IDs had restorations: OR = 0.68 [0.63, 0.73]; and 567 (13.2%) with IDs versus 2048 (15.9%) without IDs had dental extractions: OR = 0.80 [0.73, 0.89]. Group differences for attendance were greatest in younger ages, and restoration/extractions differences were greatest in older ages. Adults with IDs were more likely prescribed with anticholinergics (2493 (57.9%) vs. 6235 (48.3%): OR = 1.49 [1.39, 1.59]) and sugar-containing liquids (1641 (38.1%) vs. 2315 (17.9%): OR = 2.89 [2.67, 3.12]). CONCLUSION: Carers support dental appointments, but dentists may be less likely to restore teeth, possibly extracting multiple teeth at individual appointments instead.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12786