Abstract
Aim: The aim of the study was to evaluate the oral health status and the effectiveness of a preventive programme for mentally disabled people.
Methods: In 2008, one hundred and fifteen 18-49-year-olds from a mental hospital in Moscow, with different degrees of mental disability: mild (n=23), moderate (n=61), and severe (n=31), were examined by three calibrated dentists. Over nine months 21 patients with mild mental disability participated in the programme, which included training in oral hygiene, professional tooth-cleaning, and local fluoride application. Dental caries was assessed by DMFT, periodontal status by CPI and plaque accumulation by PHP indices. The t-test was used to compare differences in mean scores. Participants filled out questionnaires before and after the programme. The study was approved by the Ethical Committee of Moscow State University of Medicine and Dentistry.
Results: The results of the study showed that mean DMFT in the 18-25- year-old patients with mild, moderate and severe mental disability was 5.93±0.34, 9.12±0.45 and 10.42±0.40, respectively (p<0.001); the corresponding figures were 11.12±0.62, 11.50±0.64 and 17.24±0.81 in the 26-33-year- olds (p<0.001); 13.90±0.68, 15.83±0.82 and 17.80±0.95 in 34- 41-year-olds (p<0.01); 19.32±0.99, 19.53±0.98 and 22.48±1.07 in 42- 49-year-olds (p<0.05). The mean number of missing teeth increased with age in patients with mild (from 0.63±0.11 to 15.13±0.74, (p<0.001) and severe (from 4.30±0.26 to 19.70±0.81, (p<0.001) mental disability. The mean number of healthy periodontal sextants decreased from 2.17±0.18 in 18-25-year-olds to 1.12±0.11 in 41- 49-year-olds (p<0.001). The programme resulted in a decrease in dental plaque accumulation in patients with mild mental disability from 4.45±0.42 to 2.21±0.28 (p<0.001). The mean number of healthy periodontal sextants increased from 2.15±0.16 to 3.57±0.21 (p<0.001) with a reduction in the number of sextants with gingival bleeding (from 1.88±0.13 to 1.06±0.12,(p<0.001) and dental calculus (from 0.90±0.08 to 0.34±0.06, (p<0.001). Results from the questionnaire showed an increase in people who claimed to clean their teeth twice daily (from 29 to 85%), use mouthwash (from 2 to 63%) and dental floss (from 0 to 37%). The number of respondents who claimed they no longer fear dental treatment increased from 33% to 100%.
Conclusion: A high prevalence of dental caries and periodontal diseases suggests that mentally disabled people should be encouraged to take part in a preventive programme for improvement of oral hygiene skills and motivation to maintain oral health care.
The presenter of this abstract (3497) received a Borrow Travel Award
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