Oral health inequities among children with intellectual disabilities: Findings from special olympics

Background: Children with intellectual disabilities (IDs) face unique oral health challenges due to cognitive, behavioral, and physical limitations, along with barriers to accessing dental care. Data on their oral health in India remain scarce. Objective: The objective of this study is to assess the oral health status and treatment needs of athletes with ID participating in Special Olympics (SO) Bharat in Delhi. Materials and Methods: A cross-sectional survey was conducted among 499 athletes aged 6–17 years during the SO Bharat Health Fest. Oral examinations followed the Special Smiles protocol. Data on brushing, pain, caries, missing/filled teeth, fluorosis, gingival health, and treatment needs were analyzed using descriptive statistics and Chi-square tests for gender differences. Results: Overall, 88.4% reported brushing once or more daily. Dental pain was reported by 13.9% of participants. Untreated caries affected 61.9% of athletes, with molar decay in 46.9%. Females had significantly higher prevalence of untreated molar caries (53.8% vs. 41.7%; P = 0.006), missing molars (12.4% vs. 4.8%; P = 0.002), and gingival disease (34.6% vs. 25.3%; P = 0.022). Only 5.9% had filled teeth, and 7.5% had sealants. Overall, 9.2% required urgent, and 52.6% required nonurgent treatment. Conclusion: Young athletes with ID demonstrate high unmet dental needs, particularly females, with substantial levels of untreated caries and periodontal problems. Integrating preventive oral health within pediatric and school health programs, strengthening access to specialized dental services, and engaging pediatricians in early screening and referral are essential steps to reduce inequities and improve outcomes.