Dental Aspects

  • Ilan Feldberg
  • Joav Merrick


Oral hygiene and dental care is often neglected in persons with intellectual disability and good dental care can be difficult to acquire. Periodontal and dental diseases are common and can be a source of discomfort, fever, and challenging behaviors, especially because of communication difficulties. Hospitalization and treatment in general anesthesia may be necessary to provide adequate dental care, when outpatient care is impossible. Physicians should emphasize regular dental evaluations and consider mild sedation for outpatient dental visits. Evidence supports the need to develop strategies to increase patient acceptance for routine care, additional training for dentists to provide this care, and the development of more effective preventive strategies to minimize the need for this care. This chapter is based on the provision of dental service to people with intellectual disability in Israel during the past 30 years.


Down Syndrome Periodontal Disease Intellectual Disability Intellectual Disability Oral Hygiene 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Waldman HB, Perlman SP, Swerdloff M. Children with mental retardation/developmental disabilities: do physicians ever consider needed dental care?. Ment Retard. 2001;39(1):53–56.PubMedCrossRefGoogle Scholar
  2. 2.
    Waldman HB, Perlman SP. Why is providing dental care to people with mental retardation and other developmental disabilities such a low priority?. Public Health Rep. 2002;117(5):435–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Jurek GH, Reid WH. Oral health of institutionalized individuals with mental retardation. Am J Ment Retard. 1994;98(5):656–60.PubMedGoogle Scholar
  4. 4.
    Malmstrom H, Santos-Teachout R, Ren Y. Dentition and oral health. In: Prasher VP, Janicki MP, editors.. Physical health of adults with intellectual disabilities. Oxford: Blackwell; 2002. pp. 181–203.Google Scholar
  5. 5.
    Pearlman J, Sterling E. Dentistry. In: Rubin IL, Crocker AC, editors. Medical care for children and adults with developmental disabilities. Baltimore, MD: Paul H Brookes; 2006. pp. 435–49.Google Scholar
  6. 6.
    Anders PL, Davis EL. Oral health of patients with intellectual disabilities: a systematic review. Spec Care Dentist. 2010;30(3):110–17.PubMedCrossRefGoogle Scholar
  7. 7.
    Merrick J. Survey of medical clinics, 2009. Jerusalem: Office of the Medical Director, Ministry of Social Affairs; 2010.Google Scholar
  8. 8.
    Sarnat H, Sterk VV, Amir E. The dental status of 572 institutionalized mentally retarded in Israel. Isr J Dental health. 1976;24(4):11–15.Google Scholar
  9. 9.
    Lifshitz H, Merrick J. Aging among persons with intellectual disability in Israel in relation to type of residence, age, and etiology. Res Dev Disabil. 2004;25(2):193–205.PubMedCrossRefGoogle Scholar
  10. 10.
    Cohen S. Dental needs of the handicapped population living in institutions. Unpublished report, 1993.Google Scholar
  11. 11.
    Shapira J, Efrat J, Berkey D, Mann J. Dental health profile of a population with mental retardation in Israel. Spec Care Dentist. 1998;18(4):149–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Chaushu S, Yefenof EY, Becker A, Shapira J, Chaushu G. Parotid salivary immunoglobulins, recurrent respiratory tract infections and gingival health in institutionalized and non-institutionalized subject with Down syndrome. J Intellect Disabil Res. 2003;47(Pt 2):101–107.Google Scholar
  13. 13.
    Zigmond M, Stabholz A, Shapira J, Bachrach G, Chaushu G, Becker A, Yefenof E, Merrick J, Chaushu S. The outcome of a preventive dental care programme on the prevalence of localized aggressive periodontitis in Down’s syndrome individuals. J Intellect Disabil Res. 2006;50(Pt 7):492–500.PubMedCrossRefGoogle Scholar
  14. 14.
    Altabet S, Rogers K, Imes E, Boatman IM, Moncier J. Comprehensive approach towards improving oral hygiene at a state residential facility for people with mental retardation. Ment Retard. 2003;41(6):440–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Cumella S, Ransford N, Lyons J, Burnham H. Needs for oral care among people with intellectual disability not in contact with community dental services. J Intellect Disabil Res. 2000;44(1):45–52.PubMedCrossRefGoogle Scholar
  16. 16.
    Jain M, Mathur A, Sawla L, Choudhary G, Kabra K, Duraiswamy P, Kulkarni S. Oral health status of mentally disabled subjects in India. J Oral Sci. 2009;51(3):333–40.PubMedCrossRefGoogle Scholar
  17. 17.
    Merrick J, Cahana C, Lotan M, Kandel I, Carmeli E. Snoezelen or controlled multisensory stimulation. Treatment aspects from Israel. ScientificWorldJournal. 2004;4:307–14.PubMedCrossRefGoogle Scholar
  18. 18.
    Merrick J, Kandel I, Lotan M, Aspler S, Fuchs BS, Morad M. National survey 2008 on medical services for persons with intellectual disability in residential care in Israel. Int J Disabil Hum Dev. 2010;9(1):59–63.CrossRefGoogle Scholar
  19. 19.
    Merrick J. National survey 1998 on medical services for persons with intellectual disability in residential care in Israel. Int J Disabil Hum Dev. 2005;4(2):139–46.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Health Services, Division for Mental RetardationMinistry of Social Affairs, National Institute of Child Health and Human DevelopmentJerusalemIsrael
  2. 2.National Institute of Child Health and Human Development, Health Services, Division for Mental RetardationMinistry of Social Affairs and Social ServicesJerusalemIsrael
  3. 3.Kentucky Children’s Hospital, University of KentuckyLexingtonUSA

Personalised recommendations