Inequalities in Oral Health for Children with Disabilities: A French National Survey in Special Schools
Identifieur interne : 002239 ( Ncbi/Merge ); précédent : 002238; suivant : 002240Inequalities in Oral Health for Children with Disabilities: A French National Survey in Special Schools
Auteurs : Martine Hennequin [France] ; Véronique Moysan [France] ; Didier Jourdan [France] ; Martine Dorin [France] ; Emmanuel Nicolas [France]Source :
- PLoS ONE [ 1932-6203 ] ; 2008.
Abstract
Despite wide recognition that children with disability often have poor oral health, few high quality, controlled results are available.
Twenty-four objective and subjective criteria covering feeding, autonomy, access to dental care, oral hygiene, oral disease, general health and behavior were evaluated in a observational cross-sectional study of 2,487 children with disability (DC group), 4,772 adolescents with disability (DA group) and 1,641 children without disability (NDC group). Five algorithms ranked the subjects according to clinical criteria in three original oral health indices: the Clinical Oral Health Index (COHI), indicating the level of oral health problems, the Clinical Oral Care Needs Index (COCNI) giving dental care need levels, and the Clinical Oral Prevention Index (COPI) determining possible needs in terms of dental education initiatives.
DC-group children presented poorer oral health and had greater needs in both treatment and preventive oral health actions than NDC-group children (OR = 3.97, 95% CI = 3.25–4.86 for COHI; OR = 2.01, 95% CI = 1.77–2.28 for COCNI; OR = 5.25, 95% CI = 4.55–6.02 for COPI). These conditions were worse again in the DA group comparing to the DC group (OR = 3.52, 95% CI = 2.7–4.6 for COHI; OR = 1.52, 95% CI = 1.38–1.69 for COCNI; OR = 1.53, 95% CI = 1.39–1.69 for COPI).
Clinical indices generated by algorithmic association of various clinical indicators allow sensitive clinical measurement, and in this study demonstrated inequalities in oral health for children with disabilities schooling in institutions. Questions need now to be addressed as to the measures that could be taken to compensate for this situation.
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DOI: 10.1371/journal.pone.0002564
PubMed: 18575600
PubMed Central: 2432497
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administrative)</region><settlement type="city">Clermont-Ferrand</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>CHU de Clermont-Ferrand, Clermont-Ferrand, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CHU de Clermont-Ferrand, Clermont-Ferrand</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Auvergne (région administrative)</region><settlement type="city">Clermont-Ferrand</settlement></placeName></affiliation></author><author><name sortKey="Moysan, Veronique" sort="Moysan, Veronique" uniqKey="Moysan V" first="Véronique" last="Moysan">Véronique Moysan</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés 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Dorin</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Nicolas, Emmanuel" sort="Nicolas, Emmanuel" uniqKey="Nicolas E" first="Emmanuel" last="Nicolas">Emmanuel Nicolas</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>University of Auvergne (Clermont 1) EA 3847, Clermont-Ferrand, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Auvergne (Clermont 1) EA 3847, Clermont-Ferrand</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Auvergne (région administrative)</region><settlement type="city">Clermont-Ferrand</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>CHU de Clermont-Ferrand, Clermont-Ferrand, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CHU de Clermont-Ferrand, Clermont-Ferrand</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Auvergne (région administrative)</region><settlement type="city">Clermont-Ferrand</settlement></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Despite wide recognition that children with disability often have poor oral health, few high quality, controlled results are available.</p></sec><sec sec-type="methods"><title>Method</title><p>Twenty-four objective and subjective criteria covering feeding, autonomy, access to dental care, oral hygiene, oral disease, general health and behavior were evaluated in a observational cross-sectional study of 2,487 children with disability (DC group), 4,772 adolescents with disability (DA group) and 1,641 children without disability (NDC group). Five algorithms ranked the subjects according to clinical criteria in three original oral health indices: the Clinical Oral Health Index (COHI), indicating the level of oral health problems, the Clinical Oral Care Needs Index (COCNI) giving dental care need levels, and the Clinical Oral Prevention Index (COPI) determining possible needs in terms of dental education initiatives.</p></sec><sec><title>Results</title><p>DC-group children presented poorer oral health and had greater needs in both treatment and preventive oral health actions than NDC-group children (OR = 3.97, 95% CI = 3.25–4.86 for COHI; OR = 2.01, 95% CI = 1.77–2.28 for COCNI; OR = 5.25, 95% CI = 4.55–6.02 for COPI). These conditions were worse again in the DA group comparing to the DC group (OR = 3.52, 95% CI = 2.7–4.6 for COHI; OR = 1.52, 95% CI = 1.38–1.69 for COCNI; OR = 1.53, 95% CI = 1.39–1.69 for COPI).</p></sec><sec><title>Conclusion</title><p>Clinical indices generated by algorithmic association of various clinical indicators allow sensitive clinical measurement, and in this study demonstrated inequalities in oral health for children with disabilities schooling in institutions. Questions need now to be addressed as to the measures that could be taken to compensate for this situation.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title>PLoS ONE</journal-title><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18575600</article-id><article-id pub-id-type="pmc">2432497</article-id><article-id pub-id-type="publisher-id">07-PONE-RA-02482R2</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0002564</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline"><subject>Mental Health</subject><subject>Pediatrics and Child Health</subject><subject>Public Health and Epidemiology</subject></subj-group></article-categories><title-group><article-title>Inequalities in Oral Health for Children with Disabilities: A French National Survey in Special Schools</article-title><alt-title alt-title-type="running-head">Inequalities in Oral Health</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hennequin</surname><given-names>Martine</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Moysan</surname><given-names>Véronique</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jourdan</surname><given-names>Didier</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Dorin</surname><given-names>Martine</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nicolas</surname><given-names>Emmanuel</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>University of Auvergne (Clermont 1) EA 3847, Clermont-Ferrand, France</addr-line></aff><aff id="aff2"><label>2</label><addr-line>CHU de Clermont-Ferrand, Clermont-Ferrand, France</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Institut Universitaire de Formation des Maîtres, JE 2432, Clermont-Ferrand, France</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Chan</surname><given-names>An-Wen</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1">University of Toronto, Canada</aff><author-notes><corresp id="cor1">* E-mail: <email>martine.hennequin@u-clermont1.fr</email></corresp><fn fn-type="con"><p>Conceived and designed the experiments: MH VM MD. Performed the experiments: MH VM EN. Analyzed the data: MH VM MD EN. Contributed reagents/materials/analysis tools: MH VM MD EN. Wrote the paper: MH. Other: Coordinated the survey that produced the data from children without disabilities: DJ. Coordinated the survey that produced the data from children and adolescents with disabilities: MD.</p></fn></author-notes><pub-date pub-type="collection"><year>2008</year></pub-date><pub-date pub-type="epub"><day>25</day><month>6</month><year>2008</year></pub-date><volume>3</volume><issue>6</issue><elocation-id>e2564</elocation-id><history><date date-type="received"><day>13</day><month>10</month><year>2007</year></date><date date-type="accepted"><day>28</day><month>5</month><year>2008</year></date></history><copyright-statement>Hennequin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement><copyright-year>2008</copyright-year><abstract><sec><title>Background</title><p>Despite wide recognition that children with disability often have poor oral health, few high quality, controlled results are available.</p></sec><sec sec-type="methods"><title>Method</title><p>Twenty-four objective and subjective criteria covering feeding, autonomy, access to dental care, oral hygiene, oral disease, general health and behavior were evaluated in a observational cross-sectional study of 2,487 children with disability (DC group), 4,772 adolescents with disability (DA group) and 1,641 children without disability (NDC group). Five algorithms ranked the subjects according to clinical criteria in three original oral health indices: the Clinical Oral Health Index (COHI), indicating the level of oral health problems, the Clinical Oral Care Needs Index (COCNI) giving dental care need levels, and the Clinical Oral Prevention Index (COPI) determining possible needs in terms of dental education initiatives.</p></sec><sec><title>Results</title><p>DC-group children presented poorer oral health and had greater needs in both treatment and preventive oral health actions than NDC-group children (OR = 3.97, 95% CI = 3.25–4.86 for COHI; OR = 2.01, 95% CI = 1.77–2.28 for COCNI; OR = 5.25, 95% CI = 4.55–6.02 for COPI). These conditions were worse again in the DA group comparing to the DC group (OR = 3.52, 95% CI = 2.7–4.6 for COHI; OR = 1.52, 95% CI = 1.38–1.69 for COCNI; OR = 1.53, 95% CI = 1.39–1.69 for COPI).</p></sec><sec><title>Conclusion</title><p>Clinical indices generated by algorithmic association of various clinical indicators allow sensitive clinical measurement, and in this study demonstrated inequalities in oral health for children with disabilities schooling in institutions. Questions need now to be addressed as to the measures that could be taken to compensate for this situation.</p></sec></abstract><counts><page-count count="11"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>France</li></country><region><li>Auvergne (région administrative)</li><li>Auvergne-Rhône-Alpes</li><li>Île-de-France</li></region><settlement><li>Clermont-Ferrand</li><li>Paris</li></settlement></list><tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Hennequin, Martine" sort="Hennequin, Martine" uniqKey="Hennequin M" first="Martine" last="Hennequin">Martine Hennequin</name></region><name sortKey="Dorin, Martine" sort="Dorin, Martine" uniqKey="Dorin M" first="Martine" last="Dorin">Martine Dorin</name><name sortKey="Hennequin, Martine" sort="Hennequin, Martine" uniqKey="Hennequin M" first="Martine" last="Hennequin">Martine Hennequin</name><name sortKey="Jourdan, Didier" sort="Jourdan, Didier" uniqKey="Jourdan D" first="Didier" last="Jourdan">Didier Jourdan</name><name sortKey="Moysan, Veronique" sort="Moysan, Veronique" uniqKey="Moysan V" first="Véronique" last="Moysan">Véronique Moysan</name><name sortKey="Nicolas, Emmanuel" sort="Nicolas, Emmanuel" uniqKey="Nicolas E" first="Emmanuel" last="Nicolas">Emmanuel Nicolas</name><name sortKey="Nicolas, Emmanuel" sort="Nicolas, Emmanuel" uniqKey="Nicolas E" first="Emmanuel" last="Nicolas">Emmanuel Nicolas</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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