Gugnani Neeraj, Gugnani Shalini
Department of Pediatric and Preventive Dentistry, DAV (C) Dental College Yamunanagar, Yamuna Nagar, Haryana, India.
Department of Periodontics and Oral Implantology, DAV (C) Dental College Yamunanagar, Yamuna Nagar, Haryana, India.
Evid Based Dent. 2023 Mar;24(1):23-25. doi: 10.1038/s41432-023-00857-9. Epub 2023 Mar 8.
The aim of this study was to determine the access to preventive dental care and oral health among children with additional educational support needs as compared to normal children in primary education years.
This was a population-based record-linkage study, where the data was retrieved from six different national databases.
Children born in Scotland between years 2011 and 2014 and entered elementary school education in years 2016-19 were included and the corresponding information about their additional educational support needs (ASNs) was determined using a Pupil Census database. These children with intellectual disabilities were categorised as: intellectual disabilities, Autism spectrum, social learning-disabilities and other learning-disabilities. The data about their oral health, including caries experience and extractions under GA, and the data about their access to preventive dental care, including professional brushing instructions, fluoride varnish (FV) applications etc. was retrieved from other national databases. The caries experience and access to dental care was compared for these special children with that of normal children without any ASNs.
Among primary outcomes, significantly higher caries experience was recorded among children with 'social'(aRR = 1.42, CI = 1.38-1.46) and 'other'(aRR = 1.17, CI = 1.13-1.21) ASNs, while higher risk of extractions under GA was found in ID (aRR = 1.67, CI = 1.16-2.37), social (aRR = 1.24, CI = 1.08-1.42) groups while autism group showed nonsignificant higher risk (aRR = 1.12, CI = 0.79-1.53). Among secondary outcomes, significantly less attendance at general/public dental practice was recorded for all the intellectual disabilities' groups, with least attendance by children with social ASNs (aRR = 0.51 CI = 0.49-0.54). Least exposure to professional advice was received by autism group (aRR = 0.93, CI = 0.87-0.99). Further, all the groups showed less participation in nursery toothbrushing (NTB) and FV program at school; while least exposure to these preventive programs was depicted by children with social ASNs (NTB: aRR = 0.89, CI = 0.86-0.92, FV aRR = 0.95, CI = 0.92-0.98).
Children with intellectual disabilities have poor access to preventive dental care and also exhibit higher incidence of caries experience and extractions.
本研究旨在确定与小学阶段的正常儿童相比，有额外教育支持需求的儿童获得预防性牙科护理和口腔健康的情况。
这是一项基于人群的记录链接研究，数据从六个不同的国家数据库中检索。
纳入2011年至2014年在苏格兰出生并于2016 - 19年进入小学教育的儿童，并使用学生普查数据库确定他们额外教育支持需求（ASNs）的相应信息。这些有智力障碍的儿童被分类为：智力障碍、自闭症谱系、社会学习障碍和其他学习障碍。从其他国家数据库中检索他们的口腔健康数据，包括龋齿经历和全身麻醉下的拔牙情况，以及他们获得预防性牙科护理的数据，包括专业刷牙指导、氟化物涂漆（FV）应用等。将这些特殊儿童的龋齿经历和获得牙科护理的情况与没有任何ASNs的正常儿童进行比较。
在主要结果中，“社会”（aRR = 1.42，CI = 1.38 - 1.46）和“其他”（aRR = 1.17，CI = 1.13 - 1.21）ASNs儿童的龋齿经历显著更高，而在智力障碍（aRR = 1.67，CI = 1.16 - 2.37）、社会（aRR = 1.24，CI = 1.08 - 1.42）组中发现全身麻醉下拔牙的风险更高，而自闭症组显示出不显著的更高风险（aRR = 1.12，CI = 0.79 - 1.53）。在次要结果中，所有智力障碍组到普通/公共牙科诊所就诊的次数显著减少，社会ASNs儿童就诊次数最少（aRR = 0.51，CI = 0.49 - 0.54）。自闭症组获得专业建议的机会最少（aRR = 0.93，CI = 0.87 - 0.99）。此外，所有组在幼儿园刷牙（NTB）和学校FV项目中的参与度都较低；而社会ASNs儿童对这些预防项目的接触最少（NTB：aRR = 0.89，CI = 0.86 - 0.92，FV aRR = 0.95，CI = 0.92 - 0.98）。
有智力障碍的儿童获得预防性牙科护理的机会较差，并且龋齿经历和拔牙的发生率也较高。
