Supporting the oral health of people with intellectual disability: A survey of disability staffs' knowledge, perceptions, disability service barriers, and training

Parental Perspectives on Oral Health and Access to Care in Children with Down Syndrome: A Narrative Review

Background/Objectives: Children with Down syndrome are predisposed to various oro-dental conditions, which can impact their oral-health-related quality of life (OHRQoL) and overall well-being. Given their critical role, parents' and caregivers' perceptions are essential for understanding the challenges in oral care access and quality. This narrative review aimed to synthesise the available evidence on parental and caregiver perceptions regarding oral health, OHRQoL, and dental care access for children with Down syndrome. Methods: A literature search was conducted in PubMed, Web of Science, and Scopus, covering studies published between January 2015 and January 2025. The search included the keywords "Down syndrome", "oral health", "oral health-related quality of life", "caregivers", "parents", "dental care access", and "special needs children". Thirteen studies were included after applying eligibility criteria, which selected original research focusing on the target population and themes. Results: The findings highlighted that oral health significantly affects the quality of life of children with Down syndrome, influencing their functional, emotional, and social well-being. Caregivers often reported a gap between perceived and clinically observed oral health. Barriers to dental care access included insufficient training of dental professionals, financial constraints, systemic limitations, and perceived biases. Variations across different countries also revealed the influence of cultural and healthcare system factors. Conclusions: Oral health plays a critical role in the lives of children with Down syndrome and their families. Strengthening caregiver education, improving communication, validating adapted OHRQoL instruments, and enhancing dental professionals' training in special needs care are crucial steps to ensure equitable and family-centred oral healthcare.

Antibacterial Effect of Silver Nanoparticles against Oral Biofilms in Subjects with Motor and Intellectual Disabilities

BACKGROUND

Motor and intellectual disabilities (MIDs) represent a great challenge for maintaining general health due to physical and cognitive limitations, particularly in the maintenance and preservation of oral health. Silver nanoparticles (AgNPs) have emerged as a promising therapeutic tool for bacterial control, including oral biofilms; however, knowledge of the bactericidal effectiveness of oral biofilms from patients with MIDs is insufficient. This study aims to determine the antimicrobial effect of AgNPs on different oral biofilms taken from patients with and without MIDs.

METHODS

Two sizes of AgNPs were prepared and characterized by dynamic light scattering (DLS) and transmission electron microscopy (TEM). Through consecutive sampling, biofilm samples were collected from 17 subjects with MIDs and 20 subjects without disorders. The antimicrobial effect was determined by obtaining the minimum inhibitory concentration (MIC) of AgNPs, and the identification and distribution of oral bacterial species were determined by polymerase chain reaction (PCR). Finally, correlations between sociodemographic characteristics and the antimicrobial levels of AgNPs were also explored. The values of the MIC results were analyzed with IBM-SPSS software (version25) using non-parametric tests for independent groups and correlations, with statistical significance being considered as p < 0.05.

RESULTS

Both sizes of AgNPs exhibited tight particle size distributions (smaller: 10.2 ± 0.7 nm; larger: 29.3 ± 2.3 nm) with zeta potential values (-35.0 ± 3.3 and -52.6 ± 8.5 mV, respectively) confirming the stability that resulted in little to no agglomeration of nanoparticles. Although both sizes of AgNPs had good antimicrobial activity in all oral biofilms, the smallest particles had the best antimicrobial effects on the oral biofilm samples from patients with and without MIDs, even better than chlorhexidine (CHX) (p < 0.05). Likewise, the patients with disabilities showed higher levels of antimicrobial sensitivity to AgNPs compared with CHX (p < 0.05). Although the microorganisms included in the biofilms of females had a statistically higher growth level, the AgNP antimicrobial effect was statistically similar in both genders (p > 0.05). The most frequent bacteria for all oral biofilms were S. mutans (100%), P. intermedia (91.6%), T. forsythia (75.0%), T. denticola (75.0%), P. gingivalis (66.6%), F. nucleatum (66.6%), S. sobrinus (50.0%), and A. actinomycetemcomitans (8.3%).

CONCLUSIONS

AgNPs exhibited considerable antimicrobial potential to be used as a complementary and alternative tool in maintaining and preserving oral health in patients with MIDs.