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People with learning disabilities are reported to have a significantly increased incidence and severity of periodontal disease when compared to their non-disabled counterparts. The reasons for this are numerous and may include perpetuating medical conditions, personal and social circumstances, as well as poor dental access and education. Uncontrolled or advanced periodontal disease may not only cause tooth loss and its ensuing consequences but may also affect medical health, initiating or causing deterioration of systemic disease. Despite being a significant public health issue, very few data exist in current literature about the periodontal needs and treatment of patients with learning disabilities. This may largely be because research in this group is difficult and the spectrum of learning disabilities is vast. This paper aims to report on the available data in order to produce suggestions for care. This paper forms a two part series, the first of which explores preventive strategies that may be used by general dental practitioners, as well as specialists within the field, to reduce the burden of periodontal disease within this specific patient group.
CPD/Clinical Relevance: Large health inequalities exist across the population, with those with learning disabilities exhibiting much higher levels of periodontal disease and unmet dental need. Helping to reduce these inequalities is the responsibility of all dental professionals.
Article
A learning disability has been defined as a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence) and to cope independently (impaired social functioning).1 These signs occur before adulthood, and have a lasting effect on development.2
Within the UK alone, learning disabilities affect about 1.5 million people.3 The terms mild, moderate, severe and profound are currently used to make a distinction between different levels of need, however, no clear dividing lines exist. Equally, there is no clear cut-off point between people with mild learning disabilities and the general population. The category into which an individual is placed is determined by his/her IQ, the severity of medical and sensory disabilities, as well as the level of support needed in daily tasks.3
As a group, those with learning disabilities are reported to have significantly poorer oral health than their non-disabled peers with a direct relationship existing between the severity of the learning disability and the degree of oral disease.4,5 Specifically, much higher plaque indices, poorer oral hygiene and an increased prevalence and severity of chronic advanced periodontal disease has been reported in this group.6
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