By Dr Andre Clarke
Oral health is important to the health and wellbeing of people with disabilities.
Good oral health promotes communication, good nutrition, self-esteem and an enhanced quality of life. It can lead to the reduction or elimination of pain and discomfort. On the other hand, poor oral health (bad breath, overcrowded teeth or unsightly decay) reduces a person’s ability to eat nutritious food, negatively affects self image and confidence and causes significant pain.
The United Nations International Day of Persons with Disabilities was last week (December 3) and its theme this year was “Inclusion matters: access and empowerment for people of all abilities”. I hope that we can put this year’s theme into everyday practice.
The essential benefits arising from oral health cannot be underestimated. Good oral health empowers people with disabilities to face the world with more confidence, promoting their participation and contribution.
Research has shown that people with disabilities are more likely to have oral health problems and require more treatment than the rest of the population. Children with disabilities, when compared to children who do not have disabilities, have 30 per cent more untreated dental decay. They also have more extractions and less preventive work, such as fissure sealants. Adults with disabilities typically have more missing teeth, need more dental treatment and are 20 per cent more likely to have no teeth at all, if they are over 55, when compared with non-disabled adults.
The mouth health of persons with disabilities can be compromised by general risk factors. There are research findings that have pointed to possible associations between chronic mouth infections and diabetes in this population (US Surgeon General’s Report, 2000). Other research (European) indicates that persons with disabilities are at increased risk of dental decay, gum disease and mouth cancer due to poor oral hygiene, a diet high in sugars, prevalence of cigarette smoking and the effects of medication.
People with disabilities should be confident that when they go for oral health services, that they will feel important and valuable to their dentists. A good dentist should endeavour to provide quality service to all persons, even those who may have poor understanding, uncontrolled movements, limited mouth opening and/or poor posture. They should also do the same with the patient who may have limited mobility, may experience tiredness during treatment or may have medical problems.
Commonly, people with disabilities may require more specific support and re-orientation of practice and service provision in order to access mainstream oral healthcare provision. Oral health needs for persons with disabilities need to become integrated into holistic health policies and be included into general healthcare professional training. Presently, oral health is, for the most part, divorced from the general health world.
Doctors do not always think about the oral health implications of medication they might prescribe and dentists do not always request doctors’ co-management on cases often enough. The comprehensive management of the patient with disabilities is dependent on the revitalisation of the doctor-dentist team.
All mouth health is important. Someone who has a disability should be treated like someone who does not have a disability. Equality is the best policy.
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