[The mentally retarded and the dental health services. Treatment needs and preventive strategies].

Mentally retarded individuals are, since 1984 a priority group for the Norwegian public dental health service. This group of patients may have many problems which affect oral health. Difficulties with feeding are common, as are various oral motor problems like rumination, bruxism, mouth breathing and drooling. The impaired oral function may cause retention of food, reduced self-cleaning from lips and tongue and long-term use of puree food. Obstipation is a common problem which is often treated with prunes, raisins or sweetened laxatives. In behaviour modification programs sweets are often used as rewards. Tooth cleaning may cause problems for many parents and caretakers due to lack of cooperation or anatomical malformation of oral structures or teeth. Dental treatment may also be difficult to perform. Recent research in Nordic countries supports earlier reports that mentally retarded individuals have a high incidence of plaque, periodontal disease and malocclusion. Caries does not seem to be a problem. Nevertheless, older individuals with mental retardation have more untreated caries and missing teeth than average. Early intervention with oral motor training and frequent regular preventive treatment (4 x per year) will reduce caries, periodontal disease, early tooth loss and the need for treatment under general anesthesia in the future.