Dental outreach service to Hong Kong school students with visual impairment

Abstract

Previous systematic reviews have found that visually impaired children and adolescents had poorer oral health, higher prevalence of caries, periodontal inflammation and trauma experience than their sighted counterparts. There is currently insufficient data on the oral health status of this demographic in Hong Kong, yet they account for 2.7% of the population. They experience barriers when accessing professional dental care, and struggle to maintain their oral hygiene without proper guidance. To address these issues, this pilot cross-sectional study aims to provide preventive dental care service, promote oral health care, as well as to investigate the oral health conditions of visually impaired children and young adults in Hong Kong. One hundred and three students with vision impairment, aged between 6 to 21 years old, attending Ebenezer School and Home for the Visually Impaired were invited to participate in the outreach project. Consent forms and digital questionnaires were distributed to parents prior to the examination. On the day of the outreach project, simple dental check-ups were performed. Dental trauma and caries were diagnosed using the World Health Organization (WHO) criteria. Decayed-Missing-and-Filled-Teeth (DMFT) index and Visible Plaque Index (VPI) were used to assess and record the oral condition. Customized oral hygiene instructions were given to each participant following the check-up. Topical fluoride varnish and/or silver diamine fluoride (SDF) treatment was also provided according to the needs of the individual. To conclude the service, an oral health education talk was delivered to parents, caretakers and staff. Lastly, a post-service questionnaire was sent to all participants to collect feedback for programme evaluation. A total of 73 participants were recruited, with 31.5% of the participants diagnosed as severely visually impaired; 34.2% were moderately visually impaired and the rest were mildly visually impaired. Regarding their oral health behaviour, more than half (57.5%) brushed their teeth independently; and a vast majority brushed their teeth at least twice daily. 88% of the participants attended regular dental check-ups. Parents indicated via the questionnaire that the barriers to access dental care were expensive fees, uncooperative children, difficulty in finding suitable dentists and communication. A total of 32 (43.8%) participants had caries experiences (dmft or DMFT > 0). Their mean DMFT score (SD) was 1.0 (1.8). The overall mean (SD) for VPI across all students was 0.76 (0.30), and approximately one in seven experienced dental traumas. Overall, the oral health of visually impaired children and young adults is unsatisfactory. Dental caries is prevalent and oral hygiene status is poor among all age groups. of people with visual impairment. Most participants (98%) were satisfied with the service provided and felt that the outreach experience had helped improve their oral health.