March 2012

Objectives: To describe and evaluate the oral condition and oral treatment needs of the participants of the Special Olympics Special Smiles program organised in Belgium in 2008. Design: A cross-sectional study where the data were collected through interviews and clinical examinations. Participants: 687 Belgian Special Smiles athletes participated, mean age 33 years. Results: More than 70% had at least one missing tooth. Distinct signs of gingivitis and visible caries experience were observed in 44% and 22% of dentate athletes respectively. Dutch-speaking athletes were less likely to present with untreated caries (OR:0.46; 95%CI: 0.31-0.68) or with gingivitis (OR:0.51; 95%CI: 0.37-0.71) compared to their French-speaking colleagues. Signs of past injury were identified in 12% of athletes. Of those athletes with an edentulous mandible, only 53% presented with a removable denture; 73% of athletes missing some maxillary anterior teeth and 30% of those missing all anterior teeth had no prosthetic replacement in the maxilla. Nearly two fifths of athletes were referred for treatment: in 12% of athletes dental treatment was considered urgent. Conclusion: The results suggest that there is a tremendous unmet need for dental treatment in the Belgian Special Smiles population, with French-speaking athletes in greatest need. Improvements in data collection should be encouraged for example. more detailed screening methods (e.g. caries screening including enamel lesions, full periodontal examination) and questionnaires (e.g. inclusion of questions related to dietary habits, dental attendance). In this way barriers to optimal oral health (care) in this population could be further explored, attempts made to reduce them and so reduce health inequalities. Key words: oral health, Special Olympics, special smiles, caries experience, gingivitis, prostheses