Oral health characteristics of children and teenagers with special health care needs in Ile-Ife, Nigeria
Objectives: The aim of this study is to determine the prevalence of periodontal disease, dental caries and malocclusion traits in children and teenagers who have hearing impairments, visual impairments, physical impairments and intellectual disability attending special schools in Ile-Ife.
Methods: This cross-sectional comparative study comprised of children and teenagers with and without special health care needs aged 6 to 19 years who were recruited from the special schools and some regular schools in Ile-Ife. The prevalence of periodontal disease (gingivitis and periodontitis), dental caries and malocclusion traits were assessed using the Community Periodontal Index of Treatment Need, the Decayed, Missing and Filled Teeth Index and Angle's classification of malocclusion respectively. The severity of dental caries using the pulp exposure, ulceration, fistula and abscess index was also assessed. Chi-square test, Student t-test and ANOVA were conducted dp≤ 0.05 was considered statistically significant. The findings in children and teenagers with special health care needs (CTSHCN) were compared to that of children and teenagers without special health care needs in the same environment.
Results: The study sample consisted of 206 children and teenagers with special health care needs aged 6 to 19 years. 104(50.5%) were males and 102(49.5%) females. One hundred and eighty-three (88.8%) had gingivitis, 15 (7.3%) had periodontitis and this was most prevalent in those with visual impairment. Significant associations were seen between the presence of gingivitis and periodontitis (p<0.001) and types of special health care needs. The prevalence of dental caries was 22.8%; the mean DMFT/dmft was (0.20±0.60/0.28±1.06) and the mean PUFA/pufa score was (0.07±0.59/0.17±0.81). Angles class I malocclusion (85.4%) and spacing (47.1%) were the most prevalent malocclusion traits. The type of special health care needs was not associated with the presence of dental caries (p=0.49) and malocclusion traits (p=0.44). When compared to the findings in 208 children and teenagers without special health care needs, 108(51.9%) males and 100 (48.1%) females, the CTSHCN had significantly higher prevalence of periodontal disease (p=0.001) and malocclusion traits (p=0.01). There was no significant difference in the prevalence of dental caries (p=0.86) in children and teenagers with and without special health care needs.
Conclusion: CTSHCN in Ile-Ife have higher prevalence of gingivitis, periodontitis and malocclusion traits when compared to children and teenagers without special health care needs. Despite the low mean DMFT/dmft in CTSHCN in Ile-Ife, majority of the decayed teeth was left untreated and 49.0% had progressed to involve the pulp.
Key words: Special health care needs, malocclusion, dental caries, periodontal disease.