Prevalence of factors associated with edentulousness (no natural teeth) in adults with intellectual disabilities.
Adults with IDs lose all their teeth three–four times faster than peers, so flag antipsychotic use and get them to a dentist early.
01Research in Context
What this study did
Wormald et al. (2019) counted how many adults with intellectual disabilities had lost every tooth.
They looked at medical and dental records across the UK.
The team checked if age, disability level, medicine use, or poverty predicted total tooth loss.
What they found
Adults with IDs were three to four times more likely to have no natural teeth than other adults.
Tooth loss climbed sharply as people aged.
Strongest red flags were severe disability, antipsychotic drugs, and living in poor areas.
How this fits with other research
Vassos et al. (2023) extends this picture. They showed the same missing teeth cut chewing power in young adults with ID.
Bhaumik et al. (2008) saw the trend first. Special Olympics athletes with ID already had fewer teeth than the general public, foreshadowing the later numbers.
Cerutti et al. (2004) and Kawauchi et al. (2025) show the fallout: adults with ID often need heavy sedation for extractions, and obesity plus ID raises hypoxemia risk during those visits.
Why it matters
If you support adults with ID, add a quick dental screen to your intake. Note antipsychotic use and ask about daily brushing help. A referral before teeth hurt can spare pain, behavior crises, and risky sedation later.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one question to your intake: “Who helps you brush your teeth daily?” If no one, refer for dental hygiene training.
02At a glance
03Original abstract
BACKGROUND: Poor oral health is largely preventable. Prevention includes toothbrushing and regular dental checks. Oral health has important consequences for general nutrition, chewing, communication, wider systemic disease, self-confidence and participation in society. This study investigated the prevalence of edentulousness (no natural teeth) in adults with intellectual disabilities (IDs) compared with the general population and associated factors. METHODS: An adult cohort with IDs residing in Greater Glasgow and Clyde, Scotland, underwent detailed health assessments between 2002 and 2004. Between 2004 and 2006, a subsample had an oral check. Data on edentulousness in the cohort were compared with adult participants from Greater Glasgow and Clyde in the 2008 Scottish Health Survey. Within the IDs cohort, binary logistic regression analyses investigated potential relationships between edentulousness and demographic and clinical factors. RESULTS: Five hundred sixty adults with IDs were examined [53.2% (298) male, mean age = 46.3 years, range 18-81 years] and compared with 2547 general population: edentulousness was 9% vs. 1% aged 25-34 years; 22% vs. 2% aged 35-44 years; 39% vs. 7% aged 45-54 years; 41% vs. 18% aged 55-64 years; and 76% vs. 34% aged 65-74 years. In both groups, edentulousness increased with age. After stratification for age, rates of edentulousness were consistently higher in the ID cohort. Odds ratios within age strata were not homogenous (Mantel-Haenszel test, P < 0.0001). Edentulousness was more likely in those with more severe IDs (adjusted odds ratio (AOR) = 2.36; 95% confidence interval (CI) [1.23 to 4.51]); those taking antipsychotics (AOR = 2.09; 95% CI [1.25 to 3.51]) and those living in the most deprived neighbourhoods (AOR = 2.69; 95% CI [1.11 to 6.50]). There was insufficient evidence for associations with sex, type of accommodation/support, antiepileptics, problem behaviours or autism. CONCLUSIONS: Adults with IDs have a high prevalence of edentulousness and need supported daily oral care to reduce the need for extractions. Despite previous reports on poor oral care and the move towards person-centred care, carers and care-giving organisations need greater support to implement daily oral care. Prescribers need awareness of the potentially contributory role of antipsychotics, which may relate to xerostomia.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12628