Oral health status and dental service use of adults with learning disabilities living in residential institutions and in the community.

OBJECTIVE: To investigate the oral health status of adults on Sheffield's Learning Disability Case Register, and their reported use of dental services.

DESIGN: A short questionnaire interview of subjects with learning disabilities or their carers followed by a standardised epidemiological examination, by one trained and calibrated examiner.

SETTING: Residential homes, day centres or community homes of people with learning disabilities in Sheffield.

SUBJECTS: A 20% random sample of adults (18-65 years) on the register.

RESULTS: A response rate of 209 (67%) was achieved, 62% (n=130) of whom were living in the community. People living in residential care were significantly older (43.2 years) than those based in the community (36.3 years) (P<0.05). Both groups had similar mean DMFT scores; however, adults living in the community had significantly more untreated decay (DT = 1.6) and poorer oral hygiene than their counterparts in residential care (DT = 0.7). Adults in residential care had significantly more missing teeth (MT = 10.1) than those in community care (MT = 7.5). General and community dental services were the main providers of dental care. Subjects living in the community were significantly less likely to have a dentist and to use community dental services than their residential counterparts; they were more likely to attend only when having trouble.

CONCLUSIONS: Adults with learning disabilities living in the community have greater unmet oral health needs than their residential counterparts and are less likely to have regular contact with dental services. Commissioners and providers of dental services have a responsibility to ensure that the health of adults with learning disabilities is not compromised by 'normalisation'.