The complexity of tooth brushing among older adults with intellectual disabilities: Findings from a nationally representative survey.

ABSTRACT

BACKGROUND: Adults with Intellectual and Developmental Disabilities (IDD) have poor oral-hygiene and oral health. A better understanding of their oral-hygiene behaviours will inform interventions to improve personal and population health. OBJECTIVE/HYPOTHESIS: To identify the oral hygiene behaviours undertaken by and on behalf of older people with IDD. METHODS: Cross-sectional survey from the third wave of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) undertaken 2016-2017. Frequency of oral hygiene, level of support, type of brush used and for a subsample, brushing technique are reported. Bivariate analyses adopted Pearson's Chi Square test of independence. RESULTS: The sample (N = 609) had a mean age of 59.7 years (SD = 8.8); 88.4% (n = 536) reported tooth cleaning at least daily. The majority who had teeth to clean reported using standard toothbrushes (75.9%), with a minority using electric (9.6%) or modified toothbrushes (5.9%). Of the 505 who reported cleaning teeth, 285 (48.5%) did not report any assistance, 127 (25.2%) were totally dependent on another person and 133 (26.3%) reported assisted cleaning, of whom 40.0% (n = 52) were Supervised, reminded or encouraged, 27.7% (n = 36) reported Hand-on-Hand and 23.8% (n = 31) reported Brush-after-Brush techniques. An association was detected between assistance and type of toothbrush used (p < 0.001). None was detected between assistance and frequency-of-brushing (p > 0.05). CONCLUSIONS: Older adults with IDD present with a complex mix of supports, toothbrushes and techniques. This highlights the complexity of oral-hygiene behaviour for this population and indicates the need for bespoke individual care plans and complexity in interventions to improve population oral-hygiene.