title: Could Ethical Tensions in Oral Healthcare Management Revealed by Adults with Intellectual Disabilities and Caregivers Explain Unmet Oral Health Needs? Participatory Research with Focus Groups.
abstract: BACKGROUND
  Cognitively impaired patients often present poor oral health status that may be explained by ethical tensions in oral healthcare management. This participatory study explored such tensions among adults with intellectual disabilities and with caregivers. The second objective was to specify, with caregivers, the points that should be developed in a future study among dentists.
  
  
  METHODS
  Three focus groups involving adults with intellectual disabilities, family caregivers and professional caregivers were organized in France in 2013.
  
  
  RESULTS
  The thematic content analysis identified discrepancies between experiences and expectations, which were particularly marked for the dentist's competence and attitudes, the dentist's role in decisions, the dental care management and the French socio-political context.
  
  
  CONCLUSIONS
  These discrepancies could partly explain multiple attempts to find the 'right' dentist or the fact that care was abandoned, and could at least contribute to oral health needs being unmet.
authors.affiliation: Laboratory of Medical Ethics and Forensic Medicine EA 4569, University of Paris Descartes, Paris, France.|Faculty of Dentistry of Lille, Public Health Department, Lille, France.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Blaizot
authors.affiliation: Laboratory of Medical Ethics and Forensic Medicine EA 4569, University of Paris Descartes, Paris, France.|Faculty of Dentistry of Toulouse, Public Health Department, Toulouse Cedex 4, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Hamel
authors.affiliation: Laboratory of Medical Ethics and Forensic Medicine EA 4569, University of Paris Descartes, Paris, France.|Faculty of Dentistry of Paris Descartes, Dentistry Department of Louis Mourier Hospital, HUPNVS, AP-HP, Colombes, France.
authors.forename: Marysette
authors.initials: M
authors.lastname: Folliguet
authors.affiliation: Laboratory of Medical Ethics and Forensic Medicine EA 4569, University of Paris Descartes, Paris, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Herve
authors.affiliation: Laboratory of Medical Ethics and Forensic Medicine EA 4569, University of Paris Descartes, Paris, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Meningaud
authors.affiliation: Laboratory of Medical Ethics and Forensic Medicine EA 4569, University of Paris Descartes, Paris, France.|Faculty of Dentistry of Lille, Pedodontics Department, Lille, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Trentesaux
mesh_terms: D000328:Adult; D017028:Caregivers / Q000941:ethics; D055812:Community-Based Participatory Research; D003729:Dental Care / Q000941:ethics; D017144:Focus Groups; D006801:Humans; D008607:Intellectual Disability; D009909:Oral Health / Q000941:ethics; D036301:Qualitative Research
keywords: community-based participatory research; dental care; focus groups; mental competence; mentally disabled persons; qualitative research