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.