Azimi Somayyeh, Lima Fernando, Slack-Smith Linda, Bourke Jenny, Calache Hanny, Junaid Mohammed, Leonard Helen
Telethon Kids Institute, University of Western Australia, Perth, Australia.
School of Human Sciences, University of Western Australia, Perth, Australia.
Disabil Rehabil. 2022 Sep;44(19):5495-5503. doi: 10.1080/09638288.2021.1936662. Epub 2021 Jun 19.
This study investigated dental hospitalisations in Western Australian (WA) children with intellectual disability (ID) and/or autism spectrum disorder (ASD) aged up to 18 years.
Data on WA live births from 1983 to 2004 from the WA Midwives Notification System were linked to the Intellectual Disability Exploring Answers database, the WA Hospital Morbidity Data System, and the Western Australian Birth Defects Registry databases. Children were followed from birth to 2010 and the data grouped into three age-groups. Primary and secondary admissions for relevant dental diagnoses were identified and factors associated with having a dental hospitalisation investigated.
There were 1366, 1596, and 780 dental hospitalisations amongst 1122, 1154, and 609 children with ID and/or ASD in the 0-6, >6-12, and >12-18 year age groups, respectively. Children with severe ID were much more likely to be hospitalised than those with mild/moderate ID. More socioeconomically disadvantaged children were less likely to be hospitalised than children whose parents were socially advantaged.
There is concern that more vulnerable children in the WA community with ID or ASD are receiving an inadequate level of dental services compared with other groups resulting in potentially preventable hospitalisations, a situation in need of urgent remediation.Implications for rehabilitationLittle is known about why some children with intellectual disability (ID) or autism are being hospitalised for their dental care and others are not.Children with disability whose families are socioeconomically disadvantaged should have equivalent opportunity to receive optimal dental care.Dental practitioners at all levels need training and confidence in treating children with ID.
本研究调查了西澳大利亚州（WA）18岁及以下患有智力残疾（ID）和/或自闭症谱系障碍（ASD）的儿童的牙科住院情况。
将1983年至2004年西澳大利亚州助产士通报系统中关于西澳大利亚州活产的数据与智力残疾探索答案数据库、西澳大利亚州医院发病率数据系统以及西澳大利亚州出生缺陷登记数据库相链接。对儿童从出生追踪至2010年，并将数据分为三个年龄组。确定相关牙科诊断的初次和二次住院情况，并调查与牙科住院相关的因素。
在0至6岁、大于6至12岁和大于12至18岁年龄组中，分别有1122名、1154名和609名患有ID和/或ASD的儿童出现了1366次、1596次和780次牙科住院情况。重度ID儿童比轻度/中度ID儿童更有可能住院。社会经济地位较低的儿童比父母社会地位较高的儿童住院可能性更小。
令人担忧的是，与其他群体相比，西澳大利亚州社区中患有ID或ASD的更弱势儿童获得的牙科服务水平不足，导致可能可预防的住院情况，这种情况急需补救。
对康复的启示
对于为何一些患有智力残疾（ID）或自闭症的儿童因牙科护理而住院而另一些儿童没有，人们知之甚少。
家庭社会经济地位不利的残疾儿童应享有获得最佳牙科护理的同等机会。
各级牙科从业者在治疗患有ID的儿童方面需要培训和信心。
