Oral Health Status and Communication-Based Oral Health Promotion Among Athletes with Intellectual Disabilities: A Narrative Review

Abstract

Background: Athletes with intellectual disabilities experience disproportionately poor oral health despite increasing participation in organized sports and global health promotion initiatives. Untreated dental caries, periodontal diseases, inadequate oral hygiene, and limited access to preventive dental care remain common among this population. Conventional oral health promotion strategies frequently rely on verbal communication and written educational materials, which may not adequately address the cognitive and communication needs of individuals with intellectual disabilities. This review aims to synthesize current evidence regarding the oral health status of athletes with intellectual disabilities and to explore communication-based oral health promotion approaches that facilitate accessible and inclusive oral healthcare. Methods: A literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar, supplemented by publications from WHO, iADH, AAPD, and Special Olympics published between 2015-2025. Results: The literature consistently demonstrates that athletes with intellectual disabilities have a higher prevalence of untreated dental caries, gingivitis, periodontal disease, and unmet dental treatment needs than the general population. Communication barriers involving limited receptive and expressive language skills reduce oral health literacy and negatively influence preventive oral health behaviors. Discussion: Evidence indicates that communication-based interventions including visual education, Easy Read materials, caregiver-assisted education, Augmentative and Alternative Communication (AAC), and sign-supported communication improve understanding, cooperation, and oral hygiene practices. Signalong, a structured sign-supported communication system, has emerged as a promising approach to enhance oral health education through multimodal learning, although evidence in dentistry remains limited. Communication-centered oral health promotion should be incorporated into multidisciplinary healthcare programs involving dental professionals, caregivers, educators, coaches, and disability organizations. Conclussion: Future studies should evaluate the effectiveness of Signalong and other accessible communication strategies in improving oral health outcomes among athletes with intellectual disabilities.