Abstract
Objective: To identify factors associated with the quality of oral hygiene in children with mental disabilities. Methods: A cross-sectional study was conducted with a sample of 181 mentally disabled children aged three to 12 years and their mothers. The study was conducted in two public hospitals of medical care for special children in the city of Rio de Janeiro, southeastern Brazil. The children were examined on the quality of oral hygiene and presence of caries lesions. The examiner was previously calibrated and were obtained kappa values of 0.90 to 0.87 for tooth decay and oral hygiene. The mothers answered a questionnaire addressing individual characteristics, behavioral and medical history of children. The study was approved by the Ethics Committee of UFMG. Data were analyzed using the chi-square test and multivariate logistic regression, considered to be a significant 90.0%. Results: Most of the children had mild intellectual disability (56.4%) and 43.6% had moderate mental disability. The quality of oral hygiene was considered adequate in 84.0% of children. A total of 172 mothers said that her son’s teeth were brushed daily (95.0%). Among them, the majority reported difficulties in this task (53.0%). Those children diagnosed with mild intellectual disability {OR=2.82 [90% CI (1.15 to 6.86)]} and the absence of decay {OR=7.68 [90% CI (3:03 to 19:45)]} were more likely they belong to the group of children identified with an adequate oral hygiene. Conclusion: The quality of oral hygiene was associated with tooth decay and the degree of mental disability of children.
Highlights
The development of caries and periodontal disease is no different in children with disability and those without disability
The main factor in relation to the prevalence of these diseases in mentally disabled children is the inadequate removal of dental plaque normally found in this population group [1,2,3]
The sample included 181 mothers and children with mental disability. Of these 56.4% were diagnosed with mild mental disability (n=102) and 43.6% with moderate mental disability (n=79)
Summary
The development of caries and periodontal disease is no different in children with disability and those without disability. The main factor in relation to the prevalence of these diseases in mentally disabled children is the inadequate removal of dental plaque normally found in this population group [1,2,3]. The removal of dental plaque is a skill that can be mastered only when an individual has the dexterity to use a toothbrush. The brushing of teeth often requires effective movements [2]. The physical and mental limitations present in many mentally disabled individuals make the efficient brushing or flossing of teeth difficult or impossible [1,2,3,4]. The difficulties in performing this task are associated with alterations in intraoral sensibility, unwanted and/or involuntary physical movements, oral pathological reflexes and spasticity in masticatory muscles, residual food and a lack of awareness of the objective of the activity
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