Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK.
School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital and University of Glasgow Dental School, Glasgow, UK.
J Intellect Disabil Res. 2019 Nov;63(11):1359-1378. doi: 10.1111/jir.12632. Epub 2019 May 23.
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.
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.
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.
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.
过去有几项报告显示，智障成年人的口腔健康状况不佳（牙齿缺失、牙周健康和未经治疗的龋齿）。失去功能牙列会产生严重后果，包括咀嚼、吞咽、营养、言语、颞下颌关节骨关节炎和疼痛以及全身健康状况方面的问题。通过积极的口腔保健支持，大部分口腔健康问题是可以预防的。近年来，成年人的社会保健服务发生了变化，去机构化和家庭个性化护理现在是高收入国家的典型护理方式。因此，口腔健康不平等可能在减少。然而，关于这一主题的最新综合证据有限。我们旨在解决这一问题。
PROSPERO 注册号：CRD42018089880。我们对自 2008 年以来发表的文献进行了系统评价和荟萃分析，使用了首选报告项目进行系统评价和荟萃分析。使用明确的搜索策略、严格的论文选择标准、双重评分（两名评分者）、系统的数据提取和纳入文献的质量评估，对四个数据库进行了搜索。
共纳入 33/3958 篇检索文章，其中 14 篇来自牙科服务使用者，10 篇来自特殊奥林匹克运动员，因此不一定能代表更广泛的智障人群。尽管存在这一局限性，智障成年人的口腔健康状况仍然不佳。发现他们的口腔卫生和牙龈炎水平较高，许多人还患有牙周炎和未经治疗的龋齿。牙周（牙龈）和牙齿健康都存在明显的未满足需求，导致牙齿缺失。
尽管过去有报道称智障成年人的口腔健康状况不佳，尽管它是可以预防的，但口腔健康状况不佳的负担仍然很高。这凸显了提高认识的必要性，以及制定有效的日常口腔保健政策和提供适当服务的必要性。需要提高护理人员和专业人员对口腔健康的重视及其可能产生的负面影响。
