The impact of an oral health preventive programme involving parents, educators and dental professionals, on the oral health status of children and young adults with special needs attending resource centres

Abstract

The purpose of this study was to determine whether school-based oral health programs for children and young adults with special needs attending special schools Malta would be effective in bringing about behavioural change, improving oral hygiene levels and dietary choices. This cohort of the population have their particular realities that require unique approaches, unlike those employed in mainstream schools. Participants attending special schools grouped according to age [3 – 22 (n=153)] and abilities (complex communication difficulties, intellectual disabilities, multisensory impairments, profound and multiple learning difficulties) were screened twice, over a year apart, to determine their oral health needs and whether these were being met. Behaviour was scored according to the Modfied Frankl Behavior Index. The presence/absence of teeth, pain, untreated decay, restorations, missing teeth, trauma, gingivitis and the urgency for treatment were recorded using the Special Olympics International Healthy Athletes Screening (HAS) form while plaque and calculus were charted using the Oral Hygiene Index – Simplified (OHI-S). Parents and educators helped to provide insight into oral hygiene and dietary habits and barriers that individuals with special needs face regarding oral care and learning by answering two sets of questionnaires before and after the program. The Coronavirus disease 2019 (COVID-19) pandemic provided challenges but also created the possibility of exploring online teaching as a tool to connect students with healthcare professionals. Results showed that the School based Oral Health Program was effective in improving behaviour in a dental setting (p<0.001), in improving oral hygiene levels (p<0.001) and in reducing the daily exposure to cariogenic foods (p<0.001). The particular oral care and preventive advice needs for different groups of disabilities were highlighted. This study has shown that by collaborating with parents/ carers and educators, researchers succeeded in reaching and educating the people that form an essential part of the students’ support system, thus ensuring that the work done with the students can be followed up. The study has also shown that tailored school based oral health programs for students of special schools can be effective in improving the oral health experience for persons with special needs.