People with intellectual and developmental disabilities living in family or group homes are less likely to receive routine dental care than those living in institutions, according to University of Louisville School of Dentistry associate professor Catherine Binkley, D.D.S., Ph.D. These individuals also are more likely than the general population to have poor oral hygiene, increased decay and gum disease, factors that may contribute to respiratory infections -- including pneumonia.
A $308,000 National Institutes of Health grant will allow Binkley and Knowlton Johnson, PhD, senior scientist, Pacific Institute for Research and Evaluation, to conduct a two-year pilot study to pilot an intervention program for caregivers of those with IDD.
"Many social and behavioral barriers contribute to oral health disparities in people with IDD - including the resistance of many community dentists to accept Medicaid or patients with special needs, the lack of oral health literacy on the part of caregivers and uncooperative behaviors of persons with IDD when caregivers or dentists attempt to provide care," Binkley said.
The plan involves a case management strategy - an approach that has been effective in managing type II diabetes and obesity in adults and type I diabetes and asthma in children. It is designed to give caregivers - parents, guardians and staff members - knowledge and skills in providing or supervising oral hygiene for the IDD participant.
Initially, a dental hygienist assigned to the case manager role will meet with the caregiver and go over the results of the IDD participant's oral exam. They'll develop an oral health plan that includes setting goals to overcome informational, physical and behavioral obstacles to oral health.
Caregivers will participate in educational sessions and learn how to perform proper oral hygiene techniques such as brushing the teeth of a cognitively impaired person. The case manager will help the caregiver find ways to get the person with IDD to cooperate in the process, monitor the caregivers' progress in meeting goals and determine what level of support the caregiver may need in the future.
The pilot study will include 10 group homes each with three to four IDD participants.
"We believe oral health can be positively impacted through this intervention - preventing poor oral health, and possible respiratory infections in these vulnerable populations," Binkley said.
If this program can prevent the need for expensive procedures resulting from lack of proper oral health behaviors, then overall health care costs might be reduced for those with IDD.
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