Developmentally Disabled People in Toronto: Dental Health and Service Utilisation

Objectives: The purpose of this study was to examine the dental health and service needs of developmentally disabled people living in the group homes of the Toronto Association for Community Living and using its training centres. Canada has a universal health care system but dental care is not covered by publicly funded insurance, making dental care and education inaccessible for the most marginalized. Methods: The non-experimental observational study was conducted in 17 group homes and four training centres, using a convenience sampling method to recruit respondents. The survey questionnaire covered demographics, socio-economic indicators, self-reported oral health status and behaviour, and barriers to dental service utilisation. If the study participant did not know/unsure of the answer or was not able to respond due to disability, the question was referred to the caregiver. Respondents were categorised into regular users of dental care (n=143) and non-regular users (never or in emergency, n=58). Results: A total of 201 respondents (61% under age 40, 31% ages 41 to 60 and 8% over age 40) were interviewed during a week in December 2000. Bivariate and multivariate logistic regression (adjusted odds ratios) analyses identified the following significant predictors of non-regular use (p<.05): being a non-regular user of general health services (OR=1.9), having poor/fair perceived oral health (OR=2.8), not using dental hygiene devices (OR=2.1) or not having been instructed on dental hygiene (OR=3.3), and not receiving social or welfare assistance (OR=2.7). Conclusions: General health care use, oral health status, dental health awareness, dental education, and social assistance are important determinants of dental service use among developmentally disabled people in Toronto. This group has distinct needs, which separate it from the general population in Toronto and alternative dental policies should be considered. We would like to acknowledge the second-year dental hygiene students at George Brown College for help with data collection.