2017 Volume 55 Issue 3 Pages 382-389
In recent years, the number of children with severe motor and intellectual disabilities who live at home has been increasing. Although most require medical care such as tube feeding or a mechanical ventilator, the present level of medical support for disabled children living at home is not adequate. We investigated this situation, and evaluated the effectiveness of home-visit dental treatments for children with severe motor and intellectual disabilities who require a mechanical ventilator.
The subjects were 27 patients (≤15 years old, mean age 4.7±4.0 years) with severe motor and intellectual disabilities, and who required a home mechanical ventilator and received home-visit dental treatments provided by Toseikai Healthcare Corporation Life-Long Care Clinic for Disabled people from April 2015 to December 2016. We compiled information regarding basic patient characteristics, oral condition and function, and contents of the home-visit treatments. All were receiving multiple types of medical support. Nineteen patients were using a tracheostomy ventilator and 8 a nasal mask ventilator, while 22 received nutrition via a gastrostomy, 4 from naso-enteric feeding, and 1 from oral intake. Several had gingivitis or calculus deposition, and their oral functions were severely disordered. As for dental treatments, we mainly conducted oral care instruction and dysphagia rehabilitation. In cases that were difficult to treat at home, we cooperated with the related hospital. Most of the patients had no experience with visiting a dentist or had quit regular dental visits, though they were able to receive regular oral management through our home-visit dental treatment program. Our findings indicated that home-visit dental treatments are effective for children with severe motor and intellectual disabilities living at home and using a mechanical ventilator.
