Oral Health Considerations: Developmentally Disabled Adults Treated under General Anesthesia

Objectives: An estimated 20-60% of patients with disabilities require general anesthesia (GA) to facilitate dental treatment. This study investigated the prevalence of untreated decay and periodontitis in intellectually/developmentally disabled (I/DD) adults requiring GA for dental treatment and reported on dental disease and associated socio-demographic characteristics.

Methods: � This cross-sectional study utilized clinical information generated by dentists at the time of dental treatment at a state-supported system of dental clinics. Data were collected from axiUm electronic health records for I/DD adults age 20 years and older receiving dental treatment utilizing GA between 4/1/2009-3/31/2010.� Data regarding gender, age, cooperation level, type of residence, prevalence of untreated decay, and prevalence of periodontitis were compiled into a database and converted to SAS data sets for analysis (SAS 9.2).

Results: � The records of 274 I/DD patients met the inclusion criteria. Their mean (SD) age (range 20-78 years) was 43.8(11.4) years; 59% were male. All subjects were dentate. Their median cooperation level was �3� on a 7-point scale with �0� the least cooperative and �6� the most cooperative. The prevalence of untreated decay was 60% and periodontitis was 83%. �90% of the population resided in community settings (74% in small state-supported residences and 15% with their families).

Conclusions: �In this group of I/DD adults receiving dental treatment under general anesthesia, nearly two thirds were diagnosed with dental caries (60%); 8 out of 10 subjects were diagnosed with periodontitis. �The high prevalence of dental disease and marginal cooperation levels support further efforts to identify risk factors and treatment interventions, including those for community-based residences where a majority of the study population resided.�