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Authors: John Morgan, Bonnie F. Zimble

Intellectual Disability: Definitions

Summary of Major Oral Conditions

Special Care in Dentistry
John Morgan, DDS
Tufts University School of Dental Medicine, 2008


Study Questions:
     

  1. Briefly describe each of the ten oral conditions frequently found in patients with special needs, including intellectual disability (see link below).

  2. What is one implication of poor oral health for persons with intellectual disability?

  3. What is the perception many dental professionals have concerning the behavior of persons with intellectual disability? What can be done?

Major Oral Conditions of Intellectually Disabled Patients
Since intellectual disability is associated with disturbances in early development, abnormalities in the teeth and oral cavity are frequently found. For example, anomalies of the enamel and dentin often are seen in children affected by maternal rubella.

Tooth eruption may be delayed dramatically, and occur in a bizarre sequence. Microdontia, cone-shaped teeth, and other abnormalities of tooth morphology also are common, and occur at a very early age. 

Persons with intellectual disability are more prone to dental caries, malocclusion, tongue thrusting, clenching, bruxism, drooling, self-injurious behavior, and pica (a craving for unnatural articles of food). Institutionalization and oral hygiene status have been identified as significant variables affecting the oral health of individuals with intellectual disability

(The National Institute of Dental and Craniofacial Research Web site [http://www.nidcr.nih.gov] provides accurate, up-to-date information about oral health, clinical trials, patient resources, research advances, and funding and training opportunities for researchers and health professionals.)

Click on the link below to read the National Institute of Dental and Craniofacial Research (NIDCR) document, Oral Conditions in Children with Special Needs: A Guide for Health Care Providers. You will find brief descriptions and photos of conditions associated with ...

  • Oral Development: including tooth eruption, malocclusion, tooth anomalies and developmental defects

  • Oral Trauma

  • Bruxism

  • Oral Infections: including dental caries, viral infections and early, severe periodontal disease

  • Gingival Overgrowth

… in addition to a box of Tips for Health Care Providers.

In fact, a broad range of materials is available from:

National Oral Health Information Clearinghouse
1 NOHIC Way
Bethesda, MD 20892-3500
Voice: (301) 402-7364
E-mail: nohic@nidcr.nih.gov
Internet: http://www.nidcr.nih.gov/

What are the implications of intellectual disability for the patient and dental professional?

Patients with intellectual disability may struggle for social acceptance, and poor oral health may constitute an additional and unnecessary barrier.  In addition, persons with intellectual disability often are perceived by dental professionals as having “management problems.” Fortunately, most difficulties with behavior, communication, home care, and other problems can be minimized by good preparation, clear communication, and a treatment plan that takes into consideration the patient’s disabilities, needs, and potential.

Our modules continue with reviews of the following medical conditions and syndromes:

  • Cerebral Palsy

  • Down Syndrome

  • Autism Spectrum Disorders (ASD, also known as Pervasive Developmental Disorders-PDD)

  • Seizure Disorder/Epilepsy

  •  Polypharmacy

  • Spina Bifida

  • Congenital Heart Defects

  • Sturge-Weber Syndrome

  • Retts Syndrome

  • Fragile X Syndrome

  • Sensory Impairment