Oral disease represents a major health problem among individuals with disabilities.3,8,13,14
The prevalence and severity of oral disease among this group are higher when compared to the general population.6
Poor periodontal health and oral cleanliness have been observed in children with disabilities.15–18
These results may be related to the low physical abilities of these individuals and consequent difficulties in tooth brushing. Oral health may be affected by the following: limited understanding on the importance of oral health management,19
difficulties in communicating oral health needs,13
anticonvulsant medications that impact upon gum health20
and a fear of oral health procedures.7
Physical restraints and general anesthesia are commonly used to treat adults with disabilities who have fear and communication difficulties related to oral health.21
In contrast to individuals without disabilities, who usually manage their own oral health, oral health management of individuals with disabilities often depends on other people, such as parents or employees with assisted living services.6
When DMFT indexes were examined with regard to sex, the mean DMFT was found to be higher for females. This is consistent with literature, which has typically found dental caries to exhibit a higher prevalence among females than males.22–25
In one previous national population survey, rates of caries among the disabled population were found to be higher in comparison to the general population for all age groups studied.15
Not only did children with disabilities tend to have more decayed teeth when compared to children without disabilities, they also had more missing teeth and higher incidences of poor gingival health.15
However, there are quite a number of studies examining dmft and DMFT scores of disabled children, and some authors report better dmft and DMFT values among this group than among the general population of children. Shaw et al26
reported dmft and DMFT values of 1.36 and 1.85, respectively, for children with disabilities; Gizani et al16
reported a mean DMFT value of 2.9; and Shyama et al15
reported a mean DMFT of 4.5 for this group. It is most likely that the most significant factor in improving the oral health status of handicapped children is the awareness of their families of importance of oral hygiene habits.
In general, the oral hygiene of the children and young adults examined in the present study was rather poor, with heavy plaque accumulation found in approximately one in three subjects. Data from a study of 12-year-old disabled children in Flanders (Belgium) showed poor oral hygiene in 31.8% of children, with no significant differences found among disability types.16
A study of oral hygiene among mentally retarded female children in Riyadh also showed very poor oral hygiene.17
Several other studies have also found poor results for periodontal health and oral cleanliness among children with disabilities.16,18,27
These results may be due to low physical abilities, which could cause difficulties in tooth brushing among disabled children.
In our study, the frequency of decay among individuals with disabilities was found to be 84.6%. The results of the 1990 Oral Health in Turkey Report,28
which utilized the same diagnostic criteria as this study, found the prevalence of caries to be over 90% among children aged 5–6 years and approximately 80% among children 6–12 years. The report also found that dmft and DMFT values increased with age, with a mean DMFT of 4.3 for children and young adults aged 15–19 years – a value higher than that for any of the age groups in our study. There has been a recent study in Turkey by Gökalp et al,29
at age 5, only 30.2% were caries free and mean dmft was 3.7. Mean DMFT was 1.9 in 12 year-olds and raised 2.3 among 15 year-olds.