DENTAL CARE FOR LITHUANIAN PATIENTS WITH A HIGH DEGREE OF DISABILITY

Abstract

Access to professional dental care for Lithuanian patients with severe disabilities has not been previously studied.

Aim: To examine access to dental care among adult 18+ years old special needs patients in Lithuania.

Methods: The Lithuanian National Bioethics Committee approved the study and verbal consent was obtained from patients themselves or their caregivers. It was a cross- sectional study of patients with severe disabilities and special needs in continuous nursing registered with a public primary health clinic serving a population of more than 740,000 living both in the rural and urban areas. The study included persons with severe physical and/or learning disabilities for whom continuous nursing was required. The Legal List of Criteria for the Needs Assessment to Compensate Special Costs for Regular Nursing include: severe organ failures, when the Barthel ADL index is lower than a score of 20- 30, or oligoencephaly when IQ is lower than a score of 20. The study employed a survey questionnaire comprising 32 questions covering demographic and social variables including age, gender, living conditions as well as issues of access to dental care, dental treatment experience, self- perceived oral hygiene and nutrition. The information was collected through face-to-face interviews by nurses in patients’ homes. A detailed manual and on-going consultations with nurses assured quality of the data collection. All registered patients were approached.

Results: A total of 1331 patients were interviewed out of 1620 (response rate 87.2%). Their mean age was 75.7±17.8 years and 434 (32.6%) were men and 897 (67.4%) were women. From the sample 334 (21.9%) had received dental treatments during the last year, of whom 197 (59%) had prophylactic check-ups and 417 (27.3%) had had extractions. Half of the patients interviewed reported difficulties in accessing dental care and transportation was the most frequently described barrier to professional care. Half of the participants reported chewing difficulties, 734 (48.1%) of the patients brushed their teeth daily and 574 (34.6%) of patients were satisfied with their overall oral health. The majority of participants consider oral health to be an important component of an overall health.

Conclusion: Less than one third of Lithuanian patients in this sample, with a high degree of disability, had received dental care in the past year. A substantial proportion of such patients reported difficulties in accessing and receiving professional dental care.