Objective:We conducted a survey to determine the reasons for tooth extraction in disabled patients.
Materials and Methods:The study sample consisted of patients with intellectual, physical, mental, and developmental disorders who visited our clinic from April 2015 to March 2018. Patients who experienced tooth extraction (except third molars and supernumerary teeth) during the investigation period were selected from these subjects. Age, sex, diseases causing disability, and diagnoses of extracted teeth were identified from clinical records. Diagnoses of extracted teeth were divided into three groups:(1) dental caries, including intense tooth decay and apical periodontitis, (2) periodontal disease, and (3) others, including tooth fracture and trauma to the teeth. Statistical analyses were performed using the chi-square and Kruskal-Wallis tests using SPSS 25.0 for Windows (IBM Japan).
Results:During the investigation period, 897 disabled patients visited our clinic, of which 242 patients were under age 20, 438 patients were aged 20–39, 177 patients were aged 40–59, and 40 patients were over age 60. The diseases causing disability included intellectual disability (n=361), 21-trisomy (n=90), autism spectrum disorder (ASD, n=238), developmental disorders other than ASD (n=25), physical disorders (n=138), and mental disorders (n=45). The number of patients with diseases causing disability who experienced tooth extraction during the investigation period was as follows:intellectual disability 51/361 patients (14%), 21-trisomy 7/90 (8%), ASD 15/238 (6%), developmental disorders other than ASD 6/25 (24%), physical disorders 17/138 (12%) and mental disorders 18/45 (40%). In total, 114 patients experienced single or multiple tooth extraction;67 were male and 47 were female. In patients with intellectual disability, 21-trisomy, ASD, or developmental disorders other than ASD, 161 teeth were extracted due to dental caries;19 teeth due to periodontal disease;and 14 teeth due to other reasons. In patients with physical and mental disorders, 49 teeth were extracted due to dental caries;22 teeth due to periodontal disease;and 8 teeth due to other reasons.
Conclusion:With regard to intellectual disability, 21-trisomy, ASD, developmental disorders other than ASD, teeth tended to be removed more due to dental caries, compared to patients with physical and mental disorders. These results may be explained by the lower mean age of patients with intellectual disability, 21-trisomy, ASD, developmental disorders other than ASD, compared to the older age of patients with physical and mental disorders. Because disabled patients lose more teeth than healthy people, we consider that public efforts are needed to prevent caries in this population.
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