BOSTON, Mass., USA: In a study of 4,732 adults with intellectual and developmental disabilities (IDDs), researchers have found that people with such disorders are more likely to have poor oral hygiene, periodontal disease and untreated dental caries than members of the general population. Owing to behavioral difficulties associated with IDDs, the researchers believe that treatment may be deferred more often, which makes people with IDDs probably more prone to dental diseases.

Although patients in the study had access to a specialized dental program, prevalence of dental diseases was high among the participants. The researchers found that 87.8 percent (3,705) of all dentate participants (4,218) reported having had caries and 32.2 percent had untreated caries. The overall prevalence of periodontitis in the study population was 80.3 percent (3,369), with the highest among participants 60 years and older (92.6 percent). This group also demonstrated the highest prevalence of tooth loss, as 63.2 percent were edentulous. More than 10 percent of the overall study population had no teeth.

In contrast to these findings, the Centers for Disease Control and Prevention estimate that only 22.7 percent of the general population have untreated caries and not more than 7.6 are edentulous.

According to the researchers, enduring complex and time-consuming treatments can be problematic for patients with disabilities such as autism, Down syndrome and Alzheimer's disease, on the one hand. On the other hand, cognitive and behavioral limitations pose difficulties for dental practitioners when performing diagnostic and therapeutic procedures.

With regard to cooperation during dental visits, the researchers found that nearly one-quarter of the participants had only limited ability to accept any dental intervention without the application of advanced behavior management techniques and nearly 40 percent required some form of behavioral assistance to receive dental treatment. Only one-third were able to receive dental treatment without these modalities, the researchers added.

"Further research is required to identify and develop risk-based preventive interventions to manage oral disease in people with IDDs and maximize the role of the dental professional, patients and caregiver to maintain adequate oral health for people with IDDs," they concluded.

The research was carried out at the Tufts University School of Dental Medicine in Massachusetts. Data was obtained from preexisting clinical electronic dental records of adults with IDDs who were between 20 and 98 years old and had at least one dental examination between April 2009 and March 2011. They received dental care from the Tufts Dental Facilities Serving Persons with Special Needs, a statewide network of dental clinics in Massachusetts designed specifically to provide comprehensive oral health care to this population.

According to the researchers, an estimated 4.6 million Americans have an intellectual or developmental disability.

The study was published in the August issue of the Journal of the American Dental Association.