A Pradhan*, AJ Spencer, GD Slade

Background: Disabled individuals depend greatly on their carers for toothbrushing, a basic yet important marker of daily oral care. Objectives: To compare reported frequency of toothbrushing among the disabled and their carers in three residential settings. Methods: Cross-sectional survey of carers of 18-44 years olds with physical and intellectual disabilities living in three settings: with families; in community housing; or in institutions. Results: 35% of carers (n=200) returned questionnaires. 28% of the disabled lived with family, 39% in the community and 33% in an institution.

Table 1: Tooth brushing frequency among the disabled and their carers

Residential setting	% whose teeth were brushed once/day or less*
	Disabled	Carers
Family	55%	47%
Community	24%	19%
Institution	20%	14%
Total	31%	26%

* p<0.001 chi-square

Infrequent toothbrushing (once per day or less), both among disabled people and their carers, was twice as likely in family settings compared with other settings (Table 1, p<0.001). Infrequent toothbrushing was associated with age, and the average age of carers in family settings (55 years) was greater than other settings (Community=40 years; Institution=45 years).   In stratified analysis that adjusted for age, infrequent toothbrushing was still more likely in family settings compared with other settings (p<0.001).Conclusions:  Infrequent toothbrushing was more likely in family settings than community or institution settings, both for disabled people and their carers. This may reflect greater carer burden in family settings, and suggests that parents require additional support and/or training in oral hygiene.