Periodontal Treatment Involving Cooperation with of Rehabilitation Facility Staff in Periodontal Disease Patients with Intellectual Disabilities

—24-year follow-up—

Abstract

We evaluated the effects of 24-year periodontal treatment in patients with intellectual disabilities. Subjects were 27 people —14men and 13 women with an average age of 33.1 years old at the first visit—who lived at a rehabilitation facility for those with intellectual disabilities. Periodontists lectured on the importance of oral hygiene, giving instruction in tooth brushing to 14 staff members. The staff them taught subjects in daily training. Clinical examination and measurement of the gingival index (GI), periodontal pocket rate (PoR), plaque control record (PCR), and number of missing teeth were evaluated at the baseline, the termination of initial treatment, and every months in regular checkups. A significant improvement was observed in GI, PoR, and PCR following initial preparation. During 22 years of maintenance, all three measurements—GI, PoR, and PCR—were lower than at baseline. The average number of missing teeth during maintenance was 0.96 per patient. These results suggest that the staff and patients recognized the importance of oral hygiene. The staff gave oral hygiene training regularly. This together, with a checkup every 6 months, effectively maintained the oral health of patients. During maintenance, however, PCR increased slightly, mainly due to decreasing recognition of the importance of oral hygiene caused by an aging patient population and staff turnover. This indicates that more frequent checkups, i.e., every 1-3months and annual staff training are needed to maintain the oral health of patients.