Abstract
OBJECTIVE: There is limited evidence concerning oral health among disabled people capable of independently performing oral hygiene practices. This study investigated factors associated with periodontal diseases and oral hygiene status among community-dwelling, working-age Thai adults with physical disabilities. 
 
 MATERIAL & METHODS: A cross-sectional study was conducted between 1st February to 15th March 2018 at the Community Center for Independent Living, a disability community club located in Pathum Thani province, Thailand. A total of 198 adults with physical disabilities completed self-report questionnaires. Occurrence of bleeding on probing and presence of dental plaque accumulation were obtained through full-mouth periodontal examinations by a trained and calibrated examiner. Univariate and multivariate binary logistic regression were performed. 
 
 RESULTS: Toothbrushing frequency of less than twice per day was associated with periodontal diseases (OR = 8.25, p = 0.001). Higher levels of sweets consumption (OR = 3.17, p = 0.003) and infrequent toothbrushing (OR = 4.26, p = 0.001) were related to poor oral hygiene. 
 
 CONCLUSIONS: Participants who performed improper oral health behaviors would suffer from periodontal diseases and poorer oral hygiene status. Although participants are capable of performing daily self-care, their physical limitation is a possible explanation for difficulty in appropriate personal oral hygiene practices, which can lead to a lower quality of oral cleanliness. Therefore, professional oral health education and personal oral hygiene instruction tailor-fit to their specific needs are necessary to increase the quality of toothbrushing practices and proper oral health behaviors among persons with physical disabilities.
Highlights
According to the WHO global disability action plan 2014-2021, there are approximately one billion disabled people globally (WHO, 2015)
Participants who performed improper oral health behaviors would suffer from periodontal diseases and poorer oral hygiene status
Participants are capable of performing daily self-care, their physical limitation is a possible explanation for difficulty in appropriate personal oral hygiene practices, which can lead to a lower quality of oral cleanliness
Summary
According to the WHO global disability action plan 2014-2021, there are approximately one billion disabled people globally (WHO, 2015). Existing studies report that people with disabilities have poorer oral health than people without disabilities (Chen et al, 2016; Pan et al, 2017; Rashid-Kandvani, Nicolau, & Bedos, 2015) These disabled people live in complex circumstances depending on the severity of their disabilities, including difficulty functioning, experiencing a combination of diseases (Dougall & Fiske, 2008a) and deficiencies in well-organized dental care services for people with special needs (Rashid-Kandvani et al, 2015; Sermsuti-Anuwat & Pongpanich, 2018a, 2018b). There is limited evidence regarding the factors associated with periodontal diseases and oral hygiene status among independent, community-dwelling, adults with physical disabilities, who are capable of performing their own daily self-care
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