C Mac Giolla Phadraig1,2, C Griffiths3, P McCallion3,4, M McCarron3, E Donnelly-Swift1,2, J Nunn1,2. 1. Department of Child and Public Dental Health, Dublin Dental University Hospital, Dublin, Ireland. 2. School of Dental Science, Trinity College Dublin, Dublin, Ireland. 3. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland. 4. School of Social Work, Temple University, Philadelphia, PA, USA.
Abstract
OBJECTIVE: To report frequency and predictors of reported pharmacological behaviour support use among older adults with intellectual disabilities (ID) accessing dental care in Ireland. METHODS: Data from a nationally representative cross-sectional survey of adults with ID over 40 years of age allowed identification of the reported frequency of pharmacological behaviour support use. Predictors of pharmacological support were identified using multiple logistic regression. RESULTS: Most older adults with ID did not report the use of any pharmacological support to receive dental care: only 0.9% reported use of inhalation sedation; 2.4% intravenous (IV) sedation; 8.6% general anaesthesia (GA); and 16.0% oral sedation. Participants reporting challenging behaviour (OR = 1.9, 95% CI = 1.3-2.9), significant difficulty speaking (OR = 3.0, 95% CI = 1.8-4.8) and obvious oral problems (OR = 2.5, 95% CI = 1.6-4.1) had greater odds of reporting pharmacological, that is, GA or conscious sedation (CS), rather than nonpharmacological supports for dental care, compared to those who were not. CONCLUSIONS: People with ID report a diverse range of support use, with many using GA or CS, particularly oral sedation, for dental treatment. This highlights a need for training and governance for dentists who provide this care. Patients who present with challenging behaviour, oral problems and, interestingly, difficulty with expressive communication are more likely to report use of pharmacological supports. The above has implications for dental service design and delivery for this population.
OBJECTIVE: To report frequency and predictors of reported pharmacological behaviour support use among older adults with intellectual disabilities (ID) accessing dental care in Ireland. METHODS: Data from a nationally representative cross-sectional survey of adults with ID over 40 years of age allowed identification of the reported frequency of pharmacological behaviour support use. Predictors of pharmacological support were identified using multiple logistic regression. RESULTS: Most older adults with ID did not report the use of any pharmacological support to receive dental care: only 0.9% reported use of inhalation sedation; 2.4% intravenous (IV) sedation; 8.6% general anaesthesia (GA); and 16.0% oral sedation. Participants reporting challenging behaviour (OR = 1.9, 95% CI = 1.3-2.9), significant difficulty speaking (OR = 3.0, 95% CI = 1.8-4.8) and obvious oral problems (OR = 2.5, 95% CI = 1.6-4.1) had greater odds of reporting pharmacological, that is, GA or conscious sedation (CS), rather than nonpharmacological supports for dental care, compared to those who were not. CONCLUSIONS:People with ID report a diverse range of support use, with many using GA or CS, particularly oral sedation, for dental treatment. This highlights a need for training and governance for dentists who provide this care. Patients who present with challenging behaviour, oral problems and, interestingly, difficulty with expressive communication are more likely to report use of pharmacological supports. The above has implications for dental service design and delivery for this population.