How can we impact on the oral health of 0-6 year old children with disabilities in Ireland through individualized risk assessment?

Background: The only study carried out in Ireland on 0-6 year old children with disabilities showed that traditional methods of oral health promotion were ineffective. Aims: 1) to carry out an individualized risk... [ view full abstract ]

Background: The only study carried out in Ireland on 0-6 year old children with disabilities showed that traditional methods of oral health promotion were ineffective.
Aims: 1) to carry out an individualized risk assessment on a group of 0-6 year old children with disabilities using both a control and intervention group. 2) To apply a tailored oral health promotion programme and prevention program to the intervention group only 3) To re-assess risk status of both groups over an 18-month period, on 3 separate visits.
Methods: A convenience sample from 2 early intervention centres in Ireland was used. Ethical Approval was gained from 2 regions Patient demographics, risk status ,clinical data and health questionnaires were collected and collated and analysed using SPSS . A tailored oral health promotion programme was applied which was developed from the results of thematic analysis of focus groups of parents of children with disabilities 0-6 years old and this was combined with a preventative program

Findings: There were 100 children in the intervention and 80 children in the control groups, with 81% aged 3-6 years. 70% of participants were males. 49% of participants have a cognitive disability while 23% have medical and cognitive disability. 58% of participants have full medical cards. Dental decay was most prevalent in four and five year old children and in lower socioeconomic groups. There was poor knowledge on the dangers of frequency of sugar in the diet and of the relevance of fluoridated water. Individualized risk assessment recorded a high risk assessment of 42%(1st visit),44%(2nd visit) 53%(3rd visit) in the control group and 39%(1st visit),18%(2nd visit), 15%(3rd visit) in the intervention group.

Conclusions: A tailored oral health promotion package, together with clinical intervention, has proven to be very effective in reducing risk status in this cohort of patients. High risk is associated in particular with lower socioeconomic status. Oral health knowledge is poor in areas of diet and fluoridation in the caregivers of this cohort of patients’ .Individualized risk assessment will allow clinicians to assign patients appropriately into general and specialized services.