The Impact of Oral Health Education Intervention for children and young adults with Intellectual Disability In Special School : A Systematic Review
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© 2022 JETIR January 2022, Volume 9, Issue 1 www.jetir.org (ISSN-2349-5162)
The Impact of Oral Health Education
Intervention for children and young adults with
Intellectual Disability In Special School : A
Systematic Review
1
Hendry Boy, 2Muhammad Rusdi, 3Solha Elrifda, 2Intan Lestari
1
Doctoral Student University of Jambi
2
University of Jambi
3
Politecnic of Health Jambi
Coresponding author: hendryboy@poltekkesjambi.ac.id
ABSTRACT
People with intellectual disabilities with intellectual and mental limitations have a high
risk of disease teeth and mouth than normal people. Inability to brush teeth causes poor
dental and oral hygiene so that they are susceptible to dental caries and periodontal
disease. Adaptive behavior and fine motor disorders as the mainfactors causing children
and adolescents with disabilities Intellectuals have difficulty brushing their teeth. This
study aims to examine the impact of dental and oral health education interventions for
intellectually disabled children and young adults in special schools. Research is a
systematic review, by reviewing research through data sources Pub Med, Proquest,
Cochran, and Wiley, in English. There are five studies according to the criteria
inclusions. The results of a review of research articles show oral health education
interventions in special schools can improve knowledge and dental and oral hygiene of
children and adults young adults people with intellectual disabilities.
Keywords: Oral health education, Intellectual Disabity
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© 2022 JETIR January 2022, Volume 9, Issue 1 www.jetir.org (ISSN-2349-5162)
I. Background INTRODUCTION that dental plaque and Gingival inflammation will
be reduced. Purpose Assessing the impact of dental
and oral health education interventions on children
Poor oral and dental hygiene can affect a
and young adults with disabilities intellectuals in
person's quality of life, this is because of the taste
special schools.
pain and discomfort while eating, low self-esteem,
or sleep disturbances due to dental caries, including
II. Research methods
people with intellectual disabilities. Intellectual
limitations, adaptive behavior, and disorders of 2.1 Methods
motor skills cause people with intellectual This research method is a systematic review that is
disabilities to have difficulty brushing their teeth so carried out systematically using the Preferred
that they have poor oral and dental hygiene, Reporting Items for Systematic Reviews and Meta-
including in children and young adults analysis method (PRISM). Search review studies
with intellectual disabilities. This puts them at through Pub Med, Proquest, Cochran, and Wiley
greater risk of developing dental caries and disease databases, in English. Keywords intellectual
periodontitis than normal people. Intellectually disability AND dental and oral health education.
disabled children at an excellent school in the Indian The strategy used in the search for articles usingthe
city of Jodhpur experienced a prevalence of dental Picos Framework consists of 1) Population:children
caries 79.2% and lymphadenopathy (dental and young adults with intellectual disabilities
periodontal tissue abnormalities) 76.3%. Other (Down syndrome, intellectual disability) 2)
studies show the dental health status of children Intervention: Dental and Oral Health Education 3).
with intellectual disabilities, who have good Result: increased knowledge and improvement in
hygiene bad teeth, poor gum condition, and some oral hygiene 4) Study design is the research design
caries were found in permanent teeth and no used in the articles reviewed, namely: quasi-
differences in caries experience between women experimental. Article searches were carried out
and men. Rates of caries and pain experience Due to from February to October 2021.
dental caries in children and young adults, cerebral
palsy (intellectual disability) harms their quality of
life. Health promotion or special training through
dental health education and mouth should be given
to this group. American Association on Intellectual
and Developmental Disabilities (AAIDD) states
intellectual disability or mental retardation is
characterized by limitations in intellectual
functioning and adaptive behavior that includes
many social skills and in everyday life, this happens
before the age of 18. Children and young adults
with. Practically intellectual disabilities have an IQ
(Intelligence Quotients) below 70. Classification
based on IQ consists of from the light category with
an IQ of 55-70, the medium category with an IQ of
45-55, the heavy category with an IQ of 25-45, a
very severe (deep) category with IQ below 25.
Those with mild disability category and being able
to be trained in daily self-care such as brushing their
teeth, while they are in heavy and very heavy
categories should always be assisted in self-care
throughout their lives. In school-based programs,
children and young adults with intellectual
disabilities have the potential to improve their
ability to brush teeth, through individual training
with supervision, so
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Article search was carried out according to
keywords and inclusion criteria, there were 868
articles found, but After evaluating 50 articles,
5 articles met the inclusion criteria. Then, 5
articles are rated quality, which can be seen in
chart 1.
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Table 1. Summary of Literature Study Search Results for a systematic review
Author (s), year Country Research purposes design Studi Polpulatioan Duration
of publication n Participant Age Range intervention
Shyama et. Kuwait To determinate Quasi 112 Down 11-22 3 months
al2003 efectiveffectiveness of a Experimen syndrome years
short-term, school-based tal study children
supervisedtoothbrushing
program
K. Kavvadia, Athena To test a school-based Quasi 57 Intellectual Impaired 15-30 2 years
etal programmefor young adults Experimenta
2009 with intellectual impairment, by lstudy
evaluating their plaque removal
efficacy when trained weekly
for three months and the
effectiveness of this
programme, two years after
training
Kittichai.S Thailand To examine the oral health Quasi- 35 Down’s syndrome, - 1 years
and status of children with special experimen austistic,cerebral
Patcharaphol health care needs and t palsy, and mentally
2017 evaluate a retarded
preventive oral health care
program
Radhika L India The aim of this study was to quasi- 60 Phisical and 6–18 3 months
et.al2015 assess the oral hygiene status experimenta mentaldisability years
before and after supervised l
toothbrushing education
Andreia DH Brazil To assess the effects of an oral quasi- 61 Down syndrome 11-24 4 weeks
et.al2017 health education strategy experimenta Intellectual years
targetedat students with l Impairmen
disabilities
2.2 Research object intellectual disabilities before the intervention and
There are 335 total samples in the study. The after intervention to measure the success of dental
research subjects of the 5 articles are children and and oral health education interventions. Intervention
adults young people with intellectual disabilities dental and oral health education using attractive
from mild to severe (down syndrome). poster media with different colors Attractively
placed in front of the class, posters contain messages
2.3 Results about the importance of dental health. Flipcharts
Article searches were carried out according to and videos animations about dental and oral health
keywords and inclusion criteria, there were 868
are used by dental hygieniststo convey dental health
articles found, but After evaluating the 50 articles,
care messages. Videos that are played for 12
5 articles met the inclusion criteria. Then, the 5
minutes will attract attention and the motivation of
articles were assessed for quality, which can be seen
children and young adults with intellectual
in table 1.
disabilities to practice brushing teeth. Slogan dental
1. Intervention Description health through a song that keeps repeating to convey
The intervention method used by all articles is the message of dental and oral health.
to provide knowledge about dental health and
mouth and teeth brushing training for children and
young adults with intellectual disabilities.
Intervention carried out in special schools by
involving teachers and caregivers. Dental hygiene
check mouth using the OHI-S index and plaque.
Checks to measure the level of cleanliness teeth and
mouth of children and young adults with
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Table 2. Summary of Results for a systematic review
Authors Description of the intervention Outcome
Shyama et. The oral health education intervention was carried out for 3 weeks, This three- month supervised toothbrushing program was effective
al the first week starting with a dental and oral hygiene examination in reducing plaque and gingivitis scores, but the key to long-term
2003 followed by knowledge about dental and oral health in children success of the program is sustaining the children’s motivation to
with mental disabilities using attractive and attractive dental and oral make oral hygiene a part of their daily life.
health posters. Furthermore, the technique of brushing teeth is
taught. In the third week, an evaluation of knowledge and evaluation
of brushing skills was carried out.
K. Kavvadia The sample consisted of 57 students with intellectual impairment, The mean plaque scores before and after training were 10.9 and 9.3
et.al mean IQ 45 and mean age 21-years-old, who attended a special respectively. This improvement was statistically significant
2009 school in Athens, Greece and whom it was thought could be trained (p© 2022 JETIR January 2022, Volume 9, Issue 1 www.jetir.org (ISSN-2349-5162)
using posters and brushing practice for 3 months. brushing practices intellectual disability at school,
In the third month, the children's knowledge and while caregivers supervise the practice of brushing
skills of brushing teeth were evaluated and for teeth at home.
young adults with intellectual disabilities, the The results of the intervention significantly
results showed a reduction in plaque scores (1.93 to reduced the debris index in children with Down
0.95. p< 0.001) and gingivitis (2.00 to 0.83, p < syndrome and intellectual limitations. The study
0.001) and their increased motivation to Always concludes that dental health education interventions
keep your teeth and mouth healthy.10 and mouth in a short time can have a positive impact
The results of research in Athens, with a on them.9 Oral health education in the form of
sample consisting of 57 students with intellectual training on simple tooth brushing procedures carried
disabilities at school specifically, the average IQ out for children and adolescents with intellectual
was 45 and the median age was 21 years. disabilities will continuously increase motivation to
Intervention for 3 months students are given dental maintain dental and oral hygiene. Education with
and oral health materials and practice brushing teeth attractive and attractive dental health posters causes
every week, before students Dental and oral hygiene children and young adults with intellectual
were measured using the plaque index. Evaluation disabilities to be motivated to implement and apply
after 2 years with a paired T-test showed that there it in their lives. This intervention also involves
was a difference in students' plaque scores, there teachers, parents and caregivers. The involvement
was a reduction in plaque score after an of teachers in providing knowledge and skills to
intervention. The results of the study also show children and young adults with intellectual
students with disabilities intellectuals benefit from disabilities will facilitate the program to run
this intervention not only in terms of oral hygiene effectively.8, 14, 17
skills but also by increasing their attitudes and
motivation towards dental and oral health.14 4. Conclusion
The results of research in Thailand on children The results of the review article show that oral
and young adults with intellectual disabilities health education interventions for children and
amounted to 36 people. Research by providing young adults with intellectual disabilities in special
dental and oral health education schools are effective in improving knowledge and
interventionsthrough a dental health prevention skills of brushing their teeth, this is with improved
program involving teachers and caregivers for 1 hygiene teeth and mouth and their motivation to pay
years. At the beginning of the intervention, the attention to the health of their teeth and mouth. The
average DMFT score was 3.2 and the DI-S score importance of teacher and caregiver involvement in
was 2.15. after one year there is a decrease in dental health educationinterventions and the mouth
DMFT, namely 1.4 and 1.6, and the average DI-S of children and young adults with intellectual
score is 2.1. This result demonstrated by involving disabilities.
teachers and caregivers, dental health education III. Recommendations for Future Studies
interventions, and mouth effectively increases the
knowledge and motivation of children and young
adults with disabilities intellectual property in This Future studies need to be done to develop
dental and oral health.18 an oral health education intervention model with
The results of a study in India on 60 mentally intellectual disability teachers as the main
disabled children in special schools. Interventionby implementers in special schools
providing dental and oral health education and the 1. Acknowledgments
practice of brushing teeth. Duration interventionfor The author would like to thank the Promoter and
3 months. There was a significant decrease in plaque Co-Promoter of the Dissertation of the PMIPA
and gingival scores after given intervention.8 Doctoral Study Program, Jambi University for their
Research results on children with Down syndrome direction and guidance. The authors wouldalso like
and intellectual impairment (intellectual disability) to thank the anonymous reviewers fortheir valuable
in Brazil who was given dental and oral health feedback and comments
education for 5 weeks. An intervention involving
teachers and caregivers. Teachers are involved in 2. Conflict of interest
supervising children's The authors involved in this study do not declare
any competing conflicts of interest.
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