Dental health and odontogenic infections among 6- to 16-year-old German students with special health care needs (SHCN).
OBJECTIVE
This cross-sectional study aimed to assess dental health and odontogenic infections in students with special health care needs (SHCN) in the Free State of Thuringia, Germany.


METHODS
From 1283 students with SHCN aged 6-16 years, 66.0 % (n = 848 of whom are 35.7 % females and 64.3 % males) with intellectual/learning disabilities (ID/LD), physical disabilities (PD), and sensory disorders (SD) participated after informed consent in oral examinations according to WHO standards. Dental caries was assessed by dmft/DMFT, odontogenic infections by pufa/PUFA. Fissure sealants (FS) were scored in permanent molars. Data were compared to regional and national reference data and analysed by t test and age-adjusted logistic regression models.


RESULTS
Students with SHCN revealed 41.2 % caries prevalence in permanent and 31.7 % in primary teeth. Highest prevalence/experience of caries and odontogenic infections in primary teeth was recorded in 6-11-year-olds with PD (65.1 %/2.3 dmft; 14.0 %/0.3 pufa). Most affected permanent teeth were observed in students with ID/LD (12-16-year-olds 59.6 %/2.4 DMFT; 6-11-year-olds 2.8 %/0.03 PUFA). All odontogenic infections in 12-16-year-olds occurred in males; n = 9 students revealed n = 9 teeth with pufa/PUFA. Students with ID/LD aged 6-11 years exhibited lowest prevalence of FS (29.0 %) and mean of 0.8 FS. Students with SHCN suffered more than twice as frequent from untreated dental caries and benefited up to 29.0 % less from FS than peers without disabilities.


CONCLUSIONS
This first study investigating odontogenic infections of German students with SHCN revealed highest prevalence in primary teeth and in males. Oral health among students with SHCN is reduced, and FS are underutilized compared to German students without disabilities.


CONCLUSIONS
Reinforcing the application of FS in students with SHCN might contribute to reducing disparities in oral health.
Department of Preventive and Paediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany. marco.dziwak@med.uni-jena.de.
Marco
http://orcid.org/0000-0002-7497-4559
M
Dziwak
Department of Preventive and Paediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany.
Roswitha
R
Heinrich-Weltzien
Public Health Services of Erfurt, Juri-Gagarin-Ring 150, 99084, Erfurt, Germany.
Kathrin
K
Limberger
Public Health Services of Weimar, Markt 13/14, 99423, Weimar, Germany.
Susanne
S
Ifland
Public Health Services of Eichsfeld, Friedensplatz 1, 37339, Worbis, Germany.
Ilka
I
Gottstein
Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany.
Thomas
T
Lehmann
Department of Preventive and Paediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany.
Ina M
IM
Schüler
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D019988:Children with Disabilities; D005260:Female; D005491:Focal Infection, Dental / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D015995:Prevalence; D013334:Students
D010895:Pit and Fissure Sealants
Children/adolescents with special health care needs (SHCN); Dental caries; Fissure sealants; Odontogenic infections; Oral health