A Systematic Review of Oral Health Interventions to Reduce Disparities in Adults with Intellectual Disability: Results of a Novel Approach

Research consistently shows that people with I/DD experience poorer oral hygiene, higher prevalence and severity of periodontal disease, and higher incidence of untreated caries when compared to the general population. In a systematic review funded by the Centers for Disease Control (NCBDD), researchers rigorously evaluated evidence for a wide range of interventions that offer the potential to reduce those disparities. More than 4,000 titles/abstracts were identified from a literature search that included peer reviewed as well as gray literature. After criteria were applied to identify the I/DD population and intervention-studies only, the number of full text reviews was reduced to 125, and intervention categories were identified as follows: 1) sedation, appropriate use in the population; 2) education and behavioral interventions for treatment and prevention directed at individuals, caregivers and providers; 3) prevention strategies such as fluoride and chlorhexidine; and 4) access issues related to financing and funding. Researchers completed data extraction using a structured on-line tool, the Systematic Review Data Repository. The broad range of topic areas required researchers to include clinical experts in the structured review providing valuable input into the interpretation of findings, providing a measure of external validity for each reported study. A research methodologist accomplished a separate review of the studies’ internal validity, including design and statistical analyses. Results of the complimentary examinations of validity were included in the overall measure of the quality of each study and used in assigning a level of evidence to each study that was included for each topic