Perception of oral health and medical conditions as possible predictors of oral health status in visually impaired adolescents: a cross-sectional study

Abstract

Background: We aimed to assess oral health and oral hygiene status among visually impaired adolescents and also to evaluate the factors related to their oral health.

Methods: This was a cross-sectional study among 130 visually impaired adolescents in Tehran, Iran, in December 2018. Of three schools for visually impaired children in Tehran, children in the sixth to the tenth grade (aged 12-17 years) were included after obtaining their parents' consent. WHO oral health questionnaire for children was filled out through face to face interviews. General characteristics were age, gender, status of visual impairment, place of residence, and parental education level. Oral health-related questions were perceived dental and gingival health, dental self-care, dental visits, medical conditions, and dietary habits. Oral examinations included Decayed, Missing, and Filled Teeth (DMFT) index, the Simplified Oral Hygiene Index (OHI‑S), and Bleeding on Probing (BOP). Univariate and multiple logistic regression tests were applied using STATA.

Results: The mean age (SD) of the adolescents was 14.45 (1.61) years. The fully blind children were 33.8%, and those with low vision were 66.2%. Regarding the perception of dental and gingival health, nearly half of the adolescents were satisfied. The mean DMFT and decayed component (DT) were 2.43 ± 2.24 and 1.92 ± 2.12, respectively. The frequency of DMFT ≥ 3 was 45.4%. The mean OHI-S was 2.01 ± 0.70, and OHI-S > 1.8 was reported in 60% of children. The prevalence of BOP was 79.2%. DMFT was significantly associated with toothache (P = 0.003, OR = 3.70, 95% CI: 1.54-9.09), perceived dental health (P = 0.005, OR = 3.06, 95% CI: 1.40-6.67), and medical conditions (P = 0.03, OR = 3.13, 95% CI: 1.13-8.68). In addition, OHI-S was related to gender (P = 0.02, OR = 0.36, 95% CI: 0.15-0.83), perceived dental health (P = 0.006, OR = 2.87, 95% CI: 1.35-6.12) and medical conditions (P = 0.04, OR = 3.05, 95% CI: 1.04-8.97). BOP was associated with perceived gingival health (P = 0.02, OR = 2.94, 95% CI: 1.18-7.33).

Conclusions: Medical conditions and perceived dental and gingival health are possible predictors for oral health status in these adolescents. Although these children could not visualize caries or gingival bleeding during the brushing time, they could perceive the status of their oral health correctly. Also, being involved in medical problems can make more ignorance of oral health.

Keywords: Adolescents; DMFT; Iran; Oral health; School children; Visually impaired.