School of Nursing and Midwifery, Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW, 2753, Australia.
School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW, 2753, Australia.
BMC Public Health. 2019 Nov 15;19(1):1530. doi: 10.1186/s12889-019-7863-1.
People with intellectual and developmental disability (IDD) have poor oral health and need support to maintain optimal oral health outcomes. Little is known about how, when and where to intervene for this population. Thus the aim of this review was to summarise the existing evidence surrounding improving oral health outcomes for people with IDD.
A scoping literature review was conducted focusing on 'oral health' and 'intellectual disability'. Systematic searches of five electronic databases were conducted in line with the study aims and two authors independently examined all records for relevance, with consensus achieved by a third author.
A small number of approaches and interventions were identified to support people with IDD to independently maintain optimal oral hygiene. Identified studies highlighted that caregivers play a vital role in the provision of oral health support, emphasising the effectiveness of educational interventions for caregivers. However, there was uncertainty regarding the efficacy of specific tooth brushing interventions for people with IDD. In cases of more severe IDD and/or dental-related behavioural problems, dental treatment under general anaesthesia was often both a necessary and effective method of oral health care provision. The findings also identified outreach and exclusive oral health services as successful strategies for increasing the limited access of people with IDD to oral care services.
A uniform approach to supporting oral health for people with IDD is unlikely to succeed. A system-based approach is needed to address the diverse needs of the population of people with IDD, their caregivers and service context. Further high quality evidence is required to confirm these findings.
智障和发育障碍人士（IDD）的口腔健康状况较差，需要支持以维持最佳的口腔健康结果。对于该人群，何时以及在何处进行干预的相关信息知之甚少。因此，本综述的目的是总结改善智障人士口腔健康结果的现有证据。
进行了一项范围广泛的文献综述，重点关注“口腔健康”和“智力障碍”。根据研究目的，对五个电子数据库进行了系统搜索，两位作者独立检查了所有记录的相关性，由第三位作者达成共识。
确定了一些方法和干预措施来支持智障人士独立维持最佳口腔卫生。已确定的研究强调了护理人员在提供口腔健康支持方面的重要作用，突出了针对护理人员的教育干预措施的有效性。然而，对于智障人士特定的刷牙干预措施的疗效存在不确定性。在智障程度较严重和/或与牙齿相关的行为问题的情况下，全身麻醉下的牙科治疗通常是提供口腔保健的必要且有效的方法。研究结果还发现，外展和专门的口腔健康服务是增加智障人士获得口腔保健服务机会有限的成功策略。
支持智障人士口腔健康的统一方法不太可能成功。需要采用基于系统的方法来满足智障人士群体及其护理人员和服务环境的多样化需求。需要进一步的高质量证据来证实这些发现。
