Oral health status and barriers to care in a multiethnic mixed disability center: Rethinking disability community dental services.

Abstract

There are currently neither onsite services nor any known studies that addresses oral health of persons with special care needs (PSCN) within disability activity centers in Singapore. This study aims to report on the oral health status, disability-related barriers, and assess how these barriers limit care pathways. 29 PSCN from a multiethnic mixed disability day activity center were screened over two days. Their ages ranged from 18-59 years old (mean: 31.3). Proportion of Chinese, Malay and Indian ethnicity was 69.6%, 26.7% and 10.3% respectively. 11 were female. Only three PSCN were dentally fit, the average required almost four treatments each. 65.5% had "poor" to "very poor" oral hygiene. The mean number of decayed, missing and filled teeth were 2.8 (95% CI: 1.3-4.1), 1.9 (95% CI: 1.2-3.1), and 1.9 (95% CI: 1.2-3.1), respectively. DMFT had a moderate positive (Pearson's) correlation with age (rp = 0.4549, P < .05). The average British Dental Association (BDA) total banded score was 16.97, categorized as "moderate complexity." 51.7% were wheelchair users, while 41.3% needed support. Pharmacological behavioral management had to be considered for 17.2%. The odds ratio was 10 and relative risk 5.26 for requiring additional behavioral modifications and requiring more than average treatment. This multiethnic cohort of mixed disabilities displayed considerable unmet dental needs and a conflux of barriers to care. Pathways to care and study limitations are discussed.