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A systematic review of original studies was conducted to determine if differences in oral health exist between adults who have intellectual disabilities (ID) and the general population. Electronic searching identified 27 studies that met the inclusion criteria. These studies were assessed for strength of evidence. People with ID have poorer oral hygiene and higher prevalence and greater severity of periodontal disease. Caries rates in people with ID are the same as or lower than the general population. However, the rates of untreated caries are consistently higher in people with ID. Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. Evidence supports the need to develop strategies to increase patient acceptance for routine care, additional training for dentists to provide this care, and the development of more effective preventive strategies to minimize the need for this care.

During three Italian Special Olympics National Games, 365 athletes were screened. Dental and medical conditions and demographic data were recorded. The athletes were divided into two groups: those with Down syndrome (DS) and those without DS but who had intellectual disabilities (non-DS). Most of the subjects were in good systemic health. Total DMFt was 10.3 (SD 5.8; D=1.3; M=6.1; F=2.8). Decayed and filled teeth were significantly more frequent in athletes who did not have DS compared to those with DS. No significant differences were found between the two groups in the number of subjects with filled, sealed, or traumatized teeth. Athletes with DS and without DS who participated in the Italian Special Olympics had a similar oral status, which was better than Italian persons who were institutionalized and who had an intellectual disability.

The objective of this study was to assess the oral health status, treatment needs, and barriers to dental care of noninstitutionalized children in The Netherlands who have severe disabilities. The oral health status of 61 children (38% female; 4-12 years of age; M = 7.7, SD = 2.2), randomly selected from seven different daycare centers, was evaluated. Caretakers (n = 126) and dentists (n = 40) completed questionnaires concerning demographic information, oral hygiene, frequency of dental visits, and possible barriers to the daily oral care of the children. Of all the children, 57.4% had untreated caries (mean dmft/DMFT = 3.0; SD = 3.1). The proportion of caries-free children was 29.5%. In comparison to Dutch children, a significantly higher proportion of children with disabilities belonging to an ethnic minority did not receive any routine dental care (53.1% and 23.8%, respectively). Caretakers considered the noncooperation of their patients as the most troublesome aspect of their daily oral care (68%). Dentists considered communication problems as the most important barrier to treatment (75%). In conclusion, Dutch noninstitutionalized children with severe disabilities still receive a relatively low degree of quality dental care. This is particularly true for children from ethnic minority groups.

Oral health disparities between individuals with disabilities and the general population are widely reported in the literature, and malocclusion is no exception. As the number of people living with disabilities grows, so does the need to explore their oral health status. This review examines the reported prevalence of malocclusion in individuals with Down syndrome (DS), cerebral palsy (CP), cleft disorders, mental disabilities, and physical disabilities from 1976 to 2004. Malocclusion was assessed according to Angle's classifications, the Dental Aesthetic Index (DAI), and selected occlusion characteristics. The prevalence of malocclusion was higher in individuals with disabilities than in controls without disabilities. Malocclusion was more frequent when the handicap was mental rather than physical in origin. Class II and Class III malocclusions were common in individuals with CP and DS, respectively. Crowding, anterior diastema, and >1/2 cusp antero-posterior molar relations were frequent among people with disabilities. Findings varied according to disability, but were attributed to musculoskeletal abnormalities, altered cranial-base relationships, premature tooth eruption, corrective surgery, and lip incompetence. Only a deep bite was more frequent in controls compared to the individuals with disabilities.

The Helicobacter pylori (H. pylori) bacterium has been classified by the World Health Organization as a type 1 carcinogen with associations to the development of peptic and gastric ulcers, gastric carcinoma and primary B-cell lymphoma. Individuals who have intellectual disabilities and developmental disabilities (IDDD) exhibit H. pylori gastric infection at approximately twice the rate of the general population and have recurrences after triple drug treatment at a rate nearly seven times that of the general population. Gastrointestinal malignancy is reported to account for almost 50% of all cancer deaths in this population. Oral-oral and fecal-oral routes are theorized to be the primary modes of transmission for the ingestion of the bacterium. Maladaptive behaviors exhibited by individuals who have IDDD can be considered risk factors for H. pylori infection since H. pylori has been cultivated from vomitus, saliva, and feces. The purpose of this paper is to review information regarding Helicobacter pylori infection in persons with IDDD and highlight the significance of oral infection.

The Healthy Athletes Special Smiles Program provides oral health screening and data collection for athletes with mental retardation who are participating in Special Olympic events. Recently, data regarding international athletes have become available for the first time, allowing a comparison against data collected in the United States. The international athletes from the countries of China, Lebanon, Poland, South Africa, and Turkey were generally younger than those of the United States (mean age 17.4 versus 24.0 years) and were more likely to be males (64.3 versus 54.6%). The international athletes were more likely to have untreated caries (50.1 versus 28.2%), and less likely to have restorations (19.6 versus 62.9%), sealants (1.8 versus 13.5%), fluorosis (3.5 versus 8.8%), signs of gingival disease (27.8 versus 40.1%), or to be edentulous (0.1 versus 3.7%). These relationships persisted after adjustment for sex and age differences between the populations.