Fabrizio Pregliasco, MD’ *t4, Paolo Ottolina, DMD2r4,Carolina Mensi, PhDl, Daniela Carmagnola, DMP, Francexa Giussani, Public Health Nurse4Silvio Abati, MD2, Laura Strohmenger, MD3 ‘Istituto di Virologia dell’universita degli Studi, via Pascal 38,201 33 Milan, Italy; ZClinica Odontostomatologica UniversitA degli Studi, Milan, Italy; %tituto di Scienze Biomediche dell’Ospedale S. Paolo-Polo Didattico dell’Universith degli Studi, Milan, Italy, and Centro di collaborazione OMS per I’epidemiologia e la prevenzione orale; and 4Fondazione Istituto Sacra Famiglia Cesano Boscone, Milan, Italy; *corresponding author, Fabrizio.Pregliasco@unimi.it Oral health profile in an institutionalized population of Italian adults with mental retardation Spec CoreDenfist21(6):227-231, 2001 ABSTRACT The oral health of 219 residents with mental retardation living in a long-term-care institution near Milan was assessed. The dental and periodontal status, daily habits, oral hygiene, and oral mucosal status were evaluated. Of the sample, 179 (81.7%) were males. The mean age of the residents was 6 1.3 years, and the degree of cooperation was evaluated as good for 131 subjects (59.8%), fair for 79 (36.1%), and poor for nine (4.1%). The percentage of residents who were edentulous was 21.5% (47 subjects), of whom 28 subjects (59.6%) were without dentures. Evaluation showed an overall DMFT of 23.1, and the average number of missing teeth was 20.5. All subjects had periodontal disease: Forty-five subjects had calculus andor shallow pockets (4-5 mm); 61 had deep pockets (2 6 mm). The most common mucosal lesion was oral stomatitis (49.3%). These findings underline the need for special programs aimed at institutionalized subjects with mental retardation. KEY WORDS: mental retardation, epidemiology, oral health, institutionalization, DMFT, CPITN. INTRODUCTION n the last few years, knowledge about the nursing requirements for persons I with physical andlor psychological disability has increased, in particular for persons who have mental retardati~n.‘-~ It has been reported that these persons have a higher incidence of tooth decay and periodontal disease?^“ The major problems of this population are the lack of oral hygiene and other risk factors such as eating soft foods, muscle h c t i o n anomalies, bruxism, enamel blemishes, gastro-esophageal reflux, anticonwlsant medication, and morphological alteration of oro-facial structures.12 Often persons with mental retardation are not cared for adequately.’ ’ A few epidemiological studies of dental diseases in these persons have been completed in Italy,l3-I6 but none had evaluated people who were institutionalized. Some ~tudies”*’~ addressed psychiatric patients, who have characteristics and problems different from those of persons with severe intellectual and/or motor disabilities, such as those who live in the Foundation “Istituto Sacra Famiglia,” an institute situated in metropolitan Milan. The purpose of this study was to evaluate the oral health status and treatment needs of a sample of residents with mental retardation, to improve the existing internal dental services, which up to now provided only emergency care. MATERIALS 8t METHODS The “Istituto Sacra Famiglia” Foundation is a non-profit institution which provides rehabilitation and assistance for 872 persons afflicted with mental retardation. This population suffers from other associated disorders, such as motor disabilities (primarily cerebral palsy), aberrant behavior, epilepsy, and mood and impulse control disorders often associated with general medical problems. There are relatively few residents with severe motor disabilities (70% walk independently), but their ability to learn or apply knowledge, care for themselves, and communicate is generally severely impaired. For the purpose of this study, subjects were classified into two categorie~:’~ residents who were completely non-self-sufficient, those with serious physical disability and mental retardation which implied a requirement for nursing care for their primary needs; and residents who were partially self-sufficient, those able to carry out activities outside of their ward, but presenting a degree of mental impairment which resulted in difficulties with personal and oral hygiene. This cross-sectional study began in September, 1996, and continued until June, 1997. In this period, a sample of 232 residents was randomly selected on the basis of undertaking a specific treatment plan. They can be considered a 227