Blindness and Oral health
Article: A Comparison of the Oral Health Status of Children Who are Blind and Children Who are Sighted in Istanbul
by Ozdemir-Ozenen, D., Sungurtekin, E., Cildir, S., & Sandalli, N.
A comparison study was performed in Istanbul of one hundred children, in which fifty were blind and fifty had full sight. Both groups of children were age 6-10 and were all considered healthy. The aim of the study was to "evaluate the oral health status of a group of children with visual impairments in Istanbul and to compare the oral health status of these children with that of sighted children" (Ozdemir-Ozenen, Sungurtekin, Cildir, and Sandalli, 2012). All children were randomly chosen from a public school in the same socioeconomic district.
An intraoral exam was performed by a pedodontist. The visually impaired children were allowed to get used to the feel and touch of the instruments and dental chair prior to their visual examination. Each child's caries index was scored using the DMF (decayed-missing-filled), DMFT (decayed-missing-filled permanent teeth), DMFS (decayed -missing-filled permanent teeth surface), dft (decayed-filled prmary teeth), and dfs (decayed-filled primary teeth surface) indices (Ozdemir-Ozenen, Sungurtekin, Cildir, and Sandalli, 2012). In addition, periodontal indices were recorded such as the plaque index, gingival index, and oral hygiene index using the Silness and Loe Plaque and Gingival indices. Lastly the oral hygiene index was determined using the Simplified Oral hygiene Index (OHI-S).
The findings for this study were as follows:
Caries: It was found that 30% of the sighted children and 20% of the children who were blind were diagnosed as caries-free. There was also no significant difference between the boys and girls in the prevalence of dental caries. Lastly, the mean scores for the caries indices show that the visually impaired children had significantly higher values than the sighted children.
Periodontal: The results of the periodontal indices show that in regards to plaque, gingival index and oral hygiene, the visually impaired children had higher values.
The researchers believe that oral hygiene given by the dental professional is imperative. In addition, it is necessary that the tactile and technique of maintaining good oral hygiene are discussed and taught.They recognized the problems and limitations that visually impaired individuals meet. They stress the importance of the dental professional knowing how to communicate with these type of individuals. The results of their study mimics a study performed by Watson, Moles, Kumar and Porter (2010) about adults with visual problems. It was discussed by the authors that possible reasons for the outcomes they witness was due to the blind children not having as frequent dental care as compared to the sighted group. The researchers recommend that as part of oral hygiene instructions, both children and parents be included in the oral health program. Other studies incorporated the use of disclosing tablets as an education tool, however, visually impaired children would not benefit from this. For the caries results that were found, it was recommended that visually impaired children also receive nutritional guidance as to which foods would promote caries activity.
Overall, it was concluded by the researchers that visually impaired children were at a higher risk for caries and that they should seek dental attention at least four times a year. They also recommend oral hygiene instructions for not only the children, but to the parents and teachers as well, which includes the incorporation of fluoride and tooth brushing habits. As far as nutrition, it was recommended that children drink fluoridated water, and to consume calcium and phosphate-rich foods, and sugar-free chewing gum.
Personal Reflection
My parents used to say "don't sit so close to the TV,you'll hurt your eyes." My grandma on the other hand would say, "stop reading in bed while lying down- it'll hurt your eyes." Lastly, my brother would say, "You should read with more light, because it's bad for your eyes." For the most part, I never listened to any of them and I should have. I have a keen sense of smell and a sharp ear, but of all my five senses, my far sighted vision is the worse. I have no idea the reason for this, but I always attributed it to my love for reading. Since the book was held closer to me, I felt more comfortable with near objects, but since I was 19 years old, I started to notice that my vision was not as good as the rest of my senses.
Not being able to see objects from a distant is difficult for me. I feel vulnerable because from a short distance I am not able to make out specific facial features of people. I felt this vulnerability for the first time when I went jogging in the park. I could see outlines of people's faces, but if they were to stand in front of me again at a later time, I would not recognize them. My vision deficit makes driving and sitting in lectures difficult.
This is what drove me to research an article on blindness and oral health. Not being able to see or understand what is being shown can make one feel helpless and dependent on others. Because my vision is bad, I have to rely on my other senses as well such as repetition and constant hands on experience. In addition, I also find myself listening very carefully and really thinking things through. I know that I am nowhere near to being blind, but knowing without my glasses, it would be difficult for me to see very far, makes me think about how much more intense a blind persons' experiences are. In addition, I notice that also depend on my vision when doing my oral home health regimen. It's important for me to visually see if I am flossing or brushing correctly. I can imagine that if I have difficulty seeing, that I would like oral hygiene instructions that focus on my tactile strengths. I would like to be given instruments that would be easy to use and to adapt correctly without inflicting self trauma.
An intraoral exam was performed by a pedodontist. The visually impaired children were allowed to get used to the feel and touch of the instruments and dental chair prior to their visual examination. Each child's caries index was scored using the DMF (decayed-missing-filled), DMFT (decayed-missing-filled permanent teeth), DMFS (decayed -missing-filled permanent teeth surface), dft (decayed-filled prmary teeth), and dfs (decayed-filled primary teeth surface) indices (Ozdemir-Ozenen, Sungurtekin, Cildir, and Sandalli, 2012). In addition, periodontal indices were recorded such as the plaque index, gingival index, and oral hygiene index using the Silness and Loe Plaque and Gingival indices. Lastly the oral hygiene index was determined using the Simplified Oral hygiene Index (OHI-S).
The findings for this study were as follows:
Caries: It was found that 30% of the sighted children and 20% of the children who were blind were diagnosed as caries-free. There was also no significant difference between the boys and girls in the prevalence of dental caries. Lastly, the mean scores for the caries indices show that the visually impaired children had significantly higher values than the sighted children.
Periodontal: The results of the periodontal indices show that in regards to plaque, gingival index and oral hygiene, the visually impaired children had higher values.
The researchers believe that oral hygiene given by the dental professional is imperative. In addition, it is necessary that the tactile and technique of maintaining good oral hygiene are discussed and taught.They recognized the problems and limitations that visually impaired individuals meet. They stress the importance of the dental professional knowing how to communicate with these type of individuals. The results of their study mimics a study performed by Watson, Moles, Kumar and Porter (2010) about adults with visual problems. It was discussed by the authors that possible reasons for the outcomes they witness was due to the blind children not having as frequent dental care as compared to the sighted group. The researchers recommend that as part of oral hygiene instructions, both children and parents be included in the oral health program. Other studies incorporated the use of disclosing tablets as an education tool, however, visually impaired children would not benefit from this. For the caries results that were found, it was recommended that visually impaired children also receive nutritional guidance as to which foods would promote caries activity.
Overall, it was concluded by the researchers that visually impaired children were at a higher risk for caries and that they should seek dental attention at least four times a year. They also recommend oral hygiene instructions for not only the children, but to the parents and teachers as well, which includes the incorporation of fluoride and tooth brushing habits. As far as nutrition, it was recommended that children drink fluoridated water, and to consume calcium and phosphate-rich foods, and sugar-free chewing gum.
Personal Reflection
My parents used to say "don't sit so close to the TV,you'll hurt your eyes." My grandma on the other hand would say, "stop reading in bed while lying down- it'll hurt your eyes." Lastly, my brother would say, "You should read with more light, because it's bad for your eyes." For the most part, I never listened to any of them and I should have. I have a keen sense of smell and a sharp ear, but of all my five senses, my far sighted vision is the worse. I have no idea the reason for this, but I always attributed it to my love for reading. Since the book was held closer to me, I felt more comfortable with near objects, but since I was 19 years old, I started to notice that my vision was not as good as the rest of my senses.
Not being able to see objects from a distant is difficult for me. I feel vulnerable because from a short distance I am not able to make out specific facial features of people. I felt this vulnerability for the first time when I went jogging in the park. I could see outlines of people's faces, but if they were to stand in front of me again at a later time, I would not recognize them. My vision deficit makes driving and sitting in lectures difficult.
This is what drove me to research an article on blindness and oral health. Not being able to see or understand what is being shown can make one feel helpless and dependent on others. Because my vision is bad, I have to rely on my other senses as well such as repetition and constant hands on experience. In addition, I also find myself listening very carefully and really thinking things through. I know that I am nowhere near to being blind, but knowing without my glasses, it would be difficult for me to see very far, makes me think about how much more intense a blind persons' experiences are. In addition, I notice that also depend on my vision when doing my oral home health regimen. It's important for me to visually see if I am flossing or brushing correctly. I can imagine that if I have difficulty seeing, that I would like oral hygiene instructions that focus on my tactile strengths. I would like to be given instruments that would be easy to use and to adapt correctly without inflicting self trauma.
REFERENCES
Ozdemir-Ozenen, D., Sungurtekin, E., Cildir, S., & Sandalli, N. (2012). A Comparison of the Oral Health Status of Children Who Are Blind and Children Who Are Sighted in Istanbul. Journal Of Visual Impairment & Blindness, 106(6), 362-367.
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