Oral health of adults with intellectual disabilities: a systematic review.
Adults with ID still lose teeth to preventable decay—build daily brushing and gradual dentist exposure into their care plans.
01Research in Context
What this study did
The team looked at 33 past studies about teeth and gums in adults with intellectual disability. They wanted to see how much tooth decay, gum disease, and tooth loss still happen today.
Only papers about adults were kept. Kids and teens were left out. The final count gave a big-picture view of oral health across many countries.
What they found
Adults with ID still have high rates of cavities, bleeding gums, and missing teeth. Most of this damage could be prevented with daily brushing and regular dentist visits.
The review shows these problems have not gone away, even though we know how to fix them.
How this fits with other research
Conyers et al. (2004) showed that slow, live practice in the dental chair helps adults with severe ID sit through cleanings. Their single-case work is one of the very studies Dudley et al. (2019) counted, so the old finding lives inside the new review.
Dudley et al. (2019) also pulled in a Down-syndrome paper that found twice as much tooth wear in children. That paper warns about reflux and acidic drinks—risks that stay relevant as kids become adults.
Lundqvist (2013) found that six in ten adults with ID show behavior problems. Tough behaviors can block dental access, helping explain why the review still sees so much disease.
Why it matters
If you support adults with ID, treat oral care as a daily skill, not a yearly surprise. Program tooth brushing into morning and evening routines. Use the same gradual exposure Carole showed: first ride to the clinic, then sit in the chair, finally let the light shine. Track refusal and reinforce each small step. Share data with the dentist ahead of time so visits stay short and safe. Better mouths mean better meals, clearer speech, and fewer hospital days.
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02At a glance
03Original abstract
BACKGROUND: There have been several past reports that adults with intellectual disabilities experience poor oral health (tooth loss, periodontal health and untreated dental caries). Loss of a functional dentition has serious consequences, including problems with chewing, swallowing, nutrition, speech, temporomandibular joint osteoarthritis and pain and systemic health conditions. Poor oral health is largely preventable through proactive oral care support. In recent years, social care provision for adults has changed, with deinstitutionalisation and home-based personalised care now being the typical provision in high income countries. Hence, oral health inequalities might be reducing. However, there is limited recent evidence-synthesis on the topic. We aimed to address this. METHOD: PROSPERO registration number: CRD42018089880. We conducted a preferred reporting items for systematic reviews and meta-analyses systematic review of publications since 2008. Four databases were searched with a clear search strategy, strict inclusion criteria for selection of papers, double scoring (two raters), systematic data extraction and quality appraisal of included papers. RESULTS: A total of 33/3958 retrieved articles were included, of which 14 were drawn from dental service users and 10 from Special Olympic athletes, therefore not necessarily being representative of the wider population with intellectual disabilities. Despite this limitation, adults with intellectual disabilities were still shown to experience poor oral health. High levels of poor oral hygiene and gingivitis were found, with many also affected by periodontitis and untreated dental decay. There is clear unmet need relating to both periodontal (gum) and tooth health, leading to tooth loss. CONCLUSIONS: Despite reports in the past of poor oral health amongst adults with intellectual disabilities, and despite it being preventable, there remains a high burden of poor oral health. This highlights the need to raise awareness, and for polices on effective daily oral care, and appropriate service provision. The importance of oral health and its possible negative sequelae needs to be elevated amongst carers and professionals.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12632