Comparative Assessment of Oral Hygiene Practices Between Institutionalized and Non-Institutionalized Individuals with Intellectual Disabilities

Abstract

Background: Individuals with intellectual disabilities (ID) are recognized as a vulnerable population with significant unmet oral health needs. The care environment—whether institutional or community-based—may substantially influence their oral hygiene practices and clinical oral health outcomes.

Objectives: This cross-sectional study aimed to compare oral hygiene practices, caregiver involvement, and clinical oral health indices between institutionalized and non-institutionalized individuals with intellectual disabilities.

Methods: A total of 240 participants (120 institutionalized, 120 non-institutionalized) with intellectual disabilities aged 15–45 years were enrolled. Data on oral hygiene practices were collected using a structured questionnaire administered to caregivers. Clinical examination included the Oral Hygiene Index – Simplified (OHI-S), Plaque Index (PI), Gingival Index (GI), Decayed-Missing-Filled Teeth (DMFT) index, and Community Periodontal Index (CPI). Statistical analysis was performed using the Student's t-test and Chi-square test (SPSS v26.0; p < 0.05 considered significant).

Results: Non-institutionalized individuals demonstrated significantly better oral hygiene practices including higher rates of twice-daily brushing (50.8% vs. 24.2%), fluoride toothpaste use (65.0% vs. 40.0%), and regular dental visits (55.8% vs. 29.2%) (p < 0.001). Institutionalized individuals exhibited significantly higher mean OHI-S (2.81 ± 0.64 vs. 1.94 ± 0.52), PI (2.43 ± 0.58 vs. 1.71 ± 0.49), GI (1.98 ± 0.46 vs. 1.42 ± 0.38), and DMFT scores (5.34 ± 2.18 vs. 4.12 ± 1.96) (p < 0.001). Severity of ID was significantly correlated with poorer oral health in both groups.

Conclusion: Institutionalized individuals with intellectual disabilities demonstrate significantly poorer oral hygiene practices and clinical oral health status compared to their non-institutionalized counterparts. Targeted caregiver training, routine dental surveillance programs, and policy-level intervention are urgently needed to bridge this disparity.