Disability and Dental Neglect: A Population-Based Study of 70 Patients

After attending this presentation, attendees will learn more aboutchild dental neglect. This abuse does not involve physical infliction ofpain, but exposes nevertheless, the individuals to harm.This presentation will impact the forensic science communitydemonstrating how a disability predisposes sufferers to dental neglectalthough preventive dentistry and appropriate diet greatly contribute tobetter oral health.The American Academy of Pediatric Dentistry has defined dentalneglect as the “willful failure of the parent or guardian to seek andfollow through with treatment necessary to ensure a level of oral healthessential for adequate function and freedom from pain and infection.”Dental caries, periodontal diseases, and other oral conditions leftuntreated in children will have a negative effect on nutrition and facialgrowth. Dental neglect can be observed in the disabled in children andadults with severe physical or mental disorders where personal hygieneis the responsibility of the parents or guardians. In these individuals theseverity of the disability often results in the inability of autonomous oralcare. Parents and/or guardians should assist any the personal hygienewhich these individuals are not able to conduct alone, including brushingteeth and appropriate diet.To ascertain the association between patients with disabilities anddental neglect a population study of 70 patients with severe disabilitieswere observed. Dentists and dental hygienists, with the collaboration ofnurses and psychologists, visited these individuals in a rehabilitationcentre in Noicattaro (Bari) where they spend the day on educational andrehabilitation programs. The goal of the oral examination was to assessthe condition of teeth and oral soft tissue. Parents and/or guardians werealso interviewed in order to register and evaluate cultural andpsychosocial backgrounds, together with knowledge of oral hygiene andtooth brushing regimes.The results of the clinical observations showed an associationbetween disability and dental neglect. There is evidence that having adisability predisposes sufferers to dental neglect although preventivedentistry and appropriate diet greatly contribute to better oral health.Cultural attitudes and poor knowledge of basic oral hygiene appear to beassociated with dental neglect, but also insufficient provision of dentalservices specifically tailored to disabled patients’ needs. Manycaregivers neglect their oral health themselves, visiting a dental officeonly when in pain for emergency treatment. The Italian National HealthSystem provides free dental care to patients with disabilities but fewdental clinics are adequately equipped for disabled patients. Alsocommunity dentistry is given a low priority and there seems to beinsufficient prevention and educational programs on these issues.It is the opinion that child dental neglect is an underestimatedphenomena and that oral health professionals should increase theirknowledge of community dentistry and child maltreatment. Finallyfamilies should receive specific oral hygiene instructions tailored tothose with disabilities.