Hi Ankur:

In general,i think the technique of brushing and proper nutrition are the most important factors.

Look some links from Finland, Canada, U.S.A, and U.K,in different educational levels:

https://www.manitobadentist.ca/documents/Happy%20Healthy%20Teeth%20Program1-preschool%20grade%206.pdf

https://www.adelaide.edu.au/oral-health-promotion/publications/journal/Oral%20Health%20Education.pdf

http://www.ncbi.nlm.nih.gov/pubmed/7507258

http://www.nj.gov/health/fhs/oral/documents/smilesmarts_curriculum.pdf

There is also evidence that prompting can improve oral health  

http://wihd.org/wp-content/uploads/2015/02/OHara-DM-et-al..pdf

Dear Jaime González-Gómez and Justin D. Gentry

Thank  you very much for valuable links

Dear Ankur,you put such a question which is mostly ignored by the health care providers due to ignorance. This problem acts as a barrier for communication.It is therefore difficult to offer health education to the mentally challenged persons in a normal situation. But it is important that such people care about oral hygiene. I think here more meaningful is the way the message is prepared & communicate to the mentally challenged people.Here we can prepare the chart showing the various steps for oral hygiene.We can also train the one such person as a peer educator, which can be used to spread the message of oral hygiene.Here mere preaching is not required but an action much more required to improve the oral health.

Dear  Mohan Lal 

I think  to  have to  be more broaden than  the oral  hygiene

Dear Ankur,

I think properoral hygiene measures and nutritious diet. they should be somebody totake  careoftheir  oralhealth.

Dear Ishag Adam,

I am fully agree with you, but Dr. Ankur relates this topic with oral hygiene. Otherwise we should address all the public and clinical health problems in a particular community the challenged people faced should deal with the specific techniques. of health education.

Dear Dr Mohan Lal, Dr Ishag Adam,

I am in agreement with your thoughts. Specially-abled population with mental challenges have an overall lack of personal hygiene and not only oral hygiene and should be taken together. However, I feel that important parts of personal hygiene such as hand washing and bathing are usually taught to them. They are also easy to master. However oral hygiene is one part which is comparatively difficult to master. Also, dental plaque and calculus are more prevalent in this population due to anatomical reasons . Drooling is also more common. Therefore an increased emphasis has been laid on oral hygiene maintenance.  This population is known to learn complex nuromotor skills despite their disability, therefore, it might also be possible to teach them about oral hygiene in staged manner as well.

I think suggestions for health education technique would also be specific for mental competency. Where the child is totally dependent on the caregiver, the education is focused on the caregiver and I think all the ramification of oral health care provision should be taught the trainer in a way that is integrated into the general health care also. If the child has the competency to take on oral health care his or herself, the education technique should be such that promotes oral toileting as we know it. Competency would be key in taking a decision on education techniques for the child but I assume the education content would be the same

so..the primary motive should be to check the competency of the child..any evidence based tools?

One of the most important things in working with intellectually-challenged children is to first determine the child’s ability to perform the basics of daily oral hygiene by talking to the caregiver.  If the child is reportedly performing his/her own daily oral hygiene, ask the child to show you how he/she brushes, and follow up with specific recommendations on brushing methods or toothbrush adaptations.  Involve the child in hands-on demonstrations of brushing and flossing. For children who cannot brush and floss independently, talk to their caregivers about daily oral hygiene and do not assume that all caregivers know the basics. Demonstrate proper brushing and flossing techniques; work with caregivers to promote the child performing appropriate self-care, eating healthy foods, and obtaining regular oral health care; and emphasize noncariogenic foods and beverages as snacks and advise to avoid using sweets as incentives or rewards.  The oral health literacy of the caregiver, as well as the child should also be taken into account.

There are many resources and continuing education programs available for dental professionals on providing oral health care to intellectually-challenged children.  Some excellent resources you may want to explore are:

Strategies for Providing Oral Care to People with Developmental Disabilities   Available at:  http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/

This series of publications equips dental professionals with the basic information they need to deliver quality oral health care to people with special needs. The publications present an overview of physical, mental, and behavioral challenges common in patients with autism, Down syndrome, cerebral palsy, and intellectual disability and offer strategies for providing oral care. Also available are a guide for caregivers that explains home-based oral hygiene for the family member or client with special needs and a publication on safe wheelchair transfer.

Practical Oral Care for People with Developmental Disabilities

National Institute for Dental Craniofacial Research, 2008.  Available at: http://www.nidcr.nih. gov/NR/rdonlyres/ 3E80A035-7823-49AF-9701-A78B6 5490353/0/Dev Disabilities.pdf

This resource is comprised of a series of guidelines for specific conditions such as autism, cerebral palsy, Downs Syndrome, and mental retardation.  Specific topics covered include: oral health problems and challenges and strategies for care, dental caries, periodontal disease, malocclusions,  damaging oral habits, oral malformations, tooth eruption, trauma and injury, mental capabilities, behavior problems, mobility problems, neuromuscular problems, uncontrolled body movements, cardiac disorders, gastroesophageal reflux, seizures, visual impairments, hearing loss and deafness, and latex allergies.

Continuing Education: Practical Oral Care for People With Developmental Disabilities

National Institute of Dental and Craniofacial Research, National Institutes of Health. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/Continuing Education mobile.htm

This training course provides two hours of continuing education credit. Topics covered include the health challenges and strategies for care for dental patients with limited mental capacity, behavioral problems, mobility problems, neuromuscular problems,  uncontrolled body movements, cardiac disorders,  gastroesophageal reflux, seizures, visual impairments, hearing loss and deafness.  Oral health problems and strategies for care are provided for dental caries, periodontal disease, malocclusions, tooth eruption, oral malformations,  damaging oral health habits, trauma and injury.

Special Care Dentistry for the General Practice Resident: Practical Training Modules, New York State Office of Mental Retardation and Developmental Disabilities, August 23, 2012.  Available at: http://www.opwdd.ny.gov/opwdd_services_supports/oral_health/training materials.

This series consists of eight evidence based Power Point presentations designed to give a global view of dental treatment for people with special needs. The eight modules address the most important aspects of clinical medicine and dentistry required for treating a patient with special needs. Modules include: Introduction to Special Patient Care; Special Care Dentistry/Legal and Ethical Issues; Treatment Modalities/Treatment Planning for Patients with Special Needs; Learning Disabilities/Mental Retardation and Down Syndrome; Neuromuscular Disorders/ Cerebral Palsy and Muscular Dystrophy; Autistic Spectrum Disorders; Oral Manifestations/ Genetic and Congenital Disorders; and Seizure Disorders.

Oral Health Care for Children with Special Health Care Needs: A Guide for Family Members/Caregivers and Dental Providers.  Available at: http://soonersuccess.ouhsc.edu/ documents/OralHealthCare forChildrenwithSpecialHealthCare Needs-pdf.pdf

I also developed tools kits for dental and health care professionals and parents/caregivers on oral health care for children with special heath care needs and oral health literacy.  Both of these are available on Research Gate.

Having read the answers to the question Practical Oral Care for People With Developmental Disabilities I do agree with all the info provided.

Nonetheless, I would accentuate first the cause of dental care for children who cannot take care of themselves. One could start with a prescription of the abuse of sugar in children food and pass a law, first at each individual home, at your children's housing facilities in case it is an institution, and also state-wise, bypressing the food industries to add less or minimal sugar use in their products. By doing so, the first cause of tooth-cavities is taken away and practical oral care is put on the foreground.

Dear Barbara,

Thanks for providing such a useful information. It was really helpful.

Dear Jan,

Definitely nutrition forms a major role in development of oral disease and should be addressed upfront.