title: Should we educate care staff to improve the oral health and oral hygiene of people with intellectual disability in residential care? Real world lessons from a randomized controlled trial.
abstract: This study assessed the impact of a multitiered oral health educational program on the oral health and oral hygiene of people with intellectual disabilities (ID). In a controlled pretest, posttest trial, with cluster randomization, a pyramidal training program was delivered to residential staff who cared for a randomly allocated, purposively stratified intervention group of people with ID living in community care homes. A control group lived in centers where staff received no training. Clinical measures were carried out pre- and posttest. Difference in Modified Gingival Index (MGI) and Plaque Index (PI) was measured posttest using ANCOVA. Seventy-six participants took part, representing 49.0% of the invited sample (n = 155). Fourteen did not receive clinical examination. There was one dropout 6-9 months later. A 10.5% and 8.5% reduction in mean MGI and PI was evident at posttest but did not show statistically significant difference, when controlling for baseline covariates (p > 0.05, ANCOVA). Mean MGI and PI scores were not significantly different among people with ID whose care staff had and had not received oral health training. Limitations are discussed. The results indicate that this program failed to significantly improve oral health or oral hygiene, despite the intervention being "educationally" successful. More research is needed.
authors.affiliation: Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland.
authors.forename: Caoimhin
authors.initials: C
authors.lastname: Mac Giolla Phadraig
authors.forename: Suzanne
authors.initials: S
authors.lastname: Guerin
authors.forename: June
authors.initials: J
authors.lastname: Nunn
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D008607:Intellectual Disability; D008297:Male; D009910:Oral Hygiene / Q000193:education*; D058996:Quality Improvement; D012112:Residential Facilities; D020377:Self Efficacy; D000078329:Workforce
keywords: education; health promotion; intellectual disabilities; long term care; oral health; prevention