Oral Health among Children and Adolescents with Disabilities in one Welfare School in Chengdu from 2018 to 2019

Background: To identify the oral health status of children and adolescent with disabilities in one welfare school in Chengdu. With several disabilities, physical and intellectual deficiency will affect disabled children’s daily life. They pay little attention to their own health status especially oral health. Therefore, this vulnerable group require some concerns. Examining their oral health status is necessary to change their situations of low access to oral health resources and failure of describing their feelings for various reasons, which could help them reduce the rate of having oral diseases. We aim to explore the severity of caries and periodontal status among child with disabilities.

Methods: We included 173 disabled children, 92 participants in 2018 and 81 participants in 2019, who were at least three years old and less than 24. They obtained the treatment from West China Stomatological Hospital and participated in an examination of their oral health status. There were four outcomes: caries, gingivitis, dental calculus, and oral health. Although there were three indexes [decayed (dt/DT), missed (mt/MT), and filled (ft/FT) teeth] indicating decayed tooth, we combined three indexes into one (“caries”) to check whether one tooth is healthy or unhealthy. For gingivitis and dental calculus, “yes or no” is the statistical method. Oral health is a new index that represents whether one’s oral health status is healthy. If one person obtains caries or gingivitis or both, it means unhealthy. We used the logistic regression to examine how demographic characteristics (age, sex, household registration, and nationality) were jointly associated with each of the four outcomes (caries, gingivitis, dental calculus, and oral health) separately. 

Results: Four indexes (caries, gingivitis, dental calculus, and oral health) were created to determine disabled children’s oral health status. Disabled children's mean of caries was 2.77, and they shared a caries prevalence rate of 63%. 31 (17.9%) had one caries and 78 (45.1%) had two or more caries. More than 75% of had obtained fewer than five caries. For caries prevalence, we found a significantly higher prevalence of dental caries among participants aged less than 12 years (87.7%) than those aged at least 12 years (50.9%). After mutually adjustment of socio-demographic characteristics, participants aged at least 12 years had a 86% (95% CI: 65%, 94%) lower odds of having dental caries than those aged less than 12 years. For gingivitis, we found a significantly higher gingivitis detection rate among Han (87.7%) than Qiang (18.8%) and Zang (7.9%). After mutually adjustment of socio-demographic characteristics, Zang had a 81% (95% CI: 17%, 96%) lower odds of having gingivitis than Han. For dental calculus, we found a significantly higher detection rate of dental calculus among males (14.6%) than females (3.9%). After mutually adjustment of socio-demographic characteristics, females had a 376% (95% CI: 22%, 1754%) higher odds of having dental calculus than males. For oral health rate, we found a significantly higher oral health rate among participants aged at least 12 years (38.8%) than those aged less than 12 years (10.5%). After mutually adjustment of socio-demographic characteristics, participants aged at least 12 years had a 82% (95% CI: 65%, 94%) lower odds of having good oral health than those under 12 years.

Conclusions: We presented disabled children’s oral health status in three oral health criteria: caries status, periodontal health status (gingivitis and dental calculus), and general oral health status. The comprehensive oral health status of disabled children shared a high mean of caries and a high prevalence rate. Their periodontal health status was better than the Fourth National oral Health Epidemiological Survey criteria. The comprehensive oral health rate was poor. Therefore, additional studies are necessary to make improvements to it.