Association between motor proficiency and oral health in people with intellectual disabilities

Abstract

Background People with intellectual disabilities (IDs) may be at increased risk of developing periodontal diseases and dental caries due to poor oral hygiene. Our aim was to investigate motor proficiency factors associated with presence of visible plaque and gingival bleeding in people with IDs. We were particularly interested in the level of dependence, manual coordination and fine manual control of people with ID, as well as the level of exhaustion of the primary caregiver. Methods In this cross‐sectional study, 299 people with ID were evaluated for oral hygiene using the simplified Visible Plaque Index and for gum inflammation using the Gingival Bleeding Index. The Bruininks‐Oseretsky Motor Proficiency Test assessed motor proficiency through fine manual control (fine motor integration and fine motor precision) and manual coordination (manual dexterity and upper limb coordination). The level of dependence was assessed by the Katz dependency index, and the caregiver was tested for exhaustion using the fatigue severity scale. Prevalence ratios [and 95% confidence intervals (CI)] were calculated using crude and adjusted Poisson regression with robust variance. Results The exhaustion of the caregiver was associated positively to visible plaque [prevalence ratio (PR) = 1.36; 95% CI 1.06–1.65]. For gingival bleeding, people with IDs that had better fine motor integration (PR = 0.49; 95% CI 0.33–0.75) and precision (PR = 0.50; 95% CI 0.26–0.94), as well as manual dexterity (PR = 0.62, 95% CI 0.49–0.77), presented better results. Conclusion Poor oral hygiene and gum inflammation were associated with motor proficiency of people with IDs and caregivers' exhaustion. Interventions to improve the oral health of people with IDs should take into account such conditions.

Prevalencia de gingivitis inducida por biofilm dental en escolares con discapacidad intelectual de la “Unidad Educativa Especial del Azuay” y de la “Escuela de Educación Básica Fiscomisional San José de Calasanz” en la ciudad de Cuenca - Ecuador

“…dando importancia a la atención preventiva temprana en pacientes con discapacidad. (Fernandez Rojas et al, 2016;Baumgarten et al, 2021;Bagattoni et al, 2016;Nuernberg et al 2019;McGrath et al, 2019) Según varios estudios internacionales sobre el estado de salud gingival de las personas con discapacidad intelectual, reportan mayor prevalencia de gingivitis en el género masculino, resultados que fueron observados por Silness. (Couto et al, 2019;Zamora et al 2017;Ningrum et al 2020).…”

“…Los factores locales que retienen biofilm (restauraciones desbordantes, apiñamiento dental, aparatología ortodóncicos, xerostomía, etc) y factores sistémicos (tabaquismo, hormonas, diabetes, fármacos, etc), pueden modificar y exacerbar la respuesta inflamatoria ante la biopelícula bacteriana, encaminando hacia la enfermedad. (Marks et al, 2018;Baumgarten et al, 2021;Bagattoni et al, 2016;Murakami et al, 2018) La gingivitis se caracteriza clínicamente por presentar edema, sangrado, y enrojecimiento gingival; suele ser indolora, rara vez provoca hemorragia espontánea y, a menudo, se presenta con cambios clínicos sutiles. Esta enfermedad puede ser altamente recurrente, pudiendo manifestarse en pacientes con periodonto intacto, periodonto reducido sin periodontitis, o en pacientes con periodonto reducido en periodontitis tratadas con éxito.…”