title: At-home oral care for adults with developmental disabilities: a survey of caregivers.
abstract: BACKGROUND
  Little is known about effective at-home oral care methods for people with developmental disabilities (DDs) who are unable to perform personal preventive practices themselves and rely on caregivers for assistance.
  
  
  METHODS
  A convenience sample of 808 caregivers (84.5 percent paid, 15.5 percent family members) who accompanied adults with DDs (20 years or older) to appointments at a specialized statewide dental care system completed computer-assisted personal interview surveys. The authors used these data to investigate caregivers' at-home oral care experiences and to explore differences between caregivers who were paid and those who were family members.
  
  
  RESULTS
  Caregivers reported that a high proportion (85 percent) of dentate adults with DDs received assistance with tooth cleaning. They also reported a high prevalence of dental problems, and low adherence to brushing (79 percent) and flossing (22 percent) recommendations. More caregivers reported that they felt confident assisting with brushing than with flossing (85 percent versus 54 percent). Family members and paid caregivers differed with respect to confidence and training.
  
  
  CONCLUSIONS
  At-home oral care, particularly flossing, presents substantial challenges for adults with DDs. Solutions must be tailored to address the different experiences and distinct needs of the family members and paid caregivers who assist these adults.
  
  
  CONCLUSIONS
  Caregivers play an important role in providing at-home oral care, and they must be included in efforts to improve oral health outcomes for people with DDs.
authors.affiliation: Dr. Minihan is an assistant professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, Mass. 02111, e-mail paula.minihan@tufts.edu. Address correspondence to Dr. Minihan.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Minihan
authors.affiliation: Dr. Morgan is an associate professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston.
authors.forename: John P
authors.initials: JP
authors.lastname: Morgan
authors.affiliation: Ms. Park is a research analyst, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston.
authors.forename: Angel
authors.initials: A
authors.lastname: Park
authors.affiliation: Ms. Yantsides was a research assistant, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, at the time this study was conducted. She now is a senior research coordinator with Tufts University School of Medicine.
authors.forename: Konstantina E
authors.initials: KE
authors.lastname: Yantsides
authors.affiliation: Ms. Nobles was a research assistant, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, at the time this study was conducted. She now is with the University of Massachusetts, Amherst.
authors.forename: Carrie J
authors.initials: CJ
authors.lastname: Nobles
authors.affiliation: Dr. Finkelman was an assistant professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, at the time this study was conducted. He now is with the Clinical and Translational Science Institute at Tufts Medical Center and Tufts University.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Finkelman
authors.affiliation: Dr. Stark is a professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Stark
authors.affiliation: Dr. Must is a professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston.
authors.forename: Aviva
authors.initials: A
authors.lastname: Must
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D002547:Cerebral Palsy; D003147:Communication Disorders; D003430:Cross-Sectional Studies; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data; D002658:Developmental Disabilities; D004314:Down Syndrome; D004651:Employment; D005190:Family / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008607:Intellectual Disability; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene / Q000193:education / Q000706:statistics & numerical data; D012649:Self Concept; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000379:methods / Q000706:statistics & numerical data; D055815:Young Adult
keywords: People with disabilities; at-home oral care; special-care dentistry