**5. References**


ECSs are distributed widely and in increasing amounts over the world in the last few decades. ECSs exposure could occur through breastfeeding and hand-to-mouth activities in small children. In this review, epidemiological studies of children between ECSs exposure and neurodevelopmental disorders and experimental animal studies were focused. In our literature review, lead, methylmercury, pesticides, tobacco (cotinine), persistent organic pollutants such as PCBs, and environmental hormones such as bisphenol A and phthalates have been indicated association between neuronal disability and exposure levels in children. Children's brain and nervous system are vulnerable to adverse impacts from pollutants because they go through a long developmental process beginning shortly after conception and continuing through adolescence. This complex developmental process requires the precise coordination of cell growth and movement, and may be disrupted by even shortterm exposures to environmental contaminants if they occur at critical periods of development. This disruption can lead to neurodevelopmental deficits that may have an effect on the children's achievements and behaviors even though they do not result in a

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**1. Introduction** 

**17** 

*United Kingdom* 

**Disability and Oral Health** 

This chapter will address the oral health needs of people with learning disabilities and access to oral healthcare, drawing on policy, research and action in the UK. It will provide insight to the principles and practice of dental care including the creation a new dental specialty, 'Special Care Dentistry'. This dental specialty was developed to provide oral health care for vulnerable people including those with a learning disability; it provides a case study of a public health approach to developing specialist services. The case study highlights how the process has significantly improved the profile of the oral health needs of vulnerable adults in general, including people with a learning disability. The importance of promoting health using the common risk factor approach and empowering people with a disability to make healthy choices is stressed, drawing on the current evidence base. The chapter concludes with the challenges for the future which will be pertinent to those

This section will examine the disability from a UK perspective, the principles of providing healthcare for people with a learning disability and the challenges faced in doing so. Traditionally, it has been found that people with a disability or other impairment (such as a mental illness or a learning difficulty) may have worse oral health than those without such disabilities or impairments; not only can this cause physical problems, but it can potentially have a wider reaching impact as poor oral health can have a negative effect on self-esteem, quality of life and general health. Improving the levels of oral health in those with impairments or disabilities is, consequently, a major issue for the dental care

At a global level, it is suggested that approximately 10% of the world's population, more than half a billion people, are disabled and it is predicted that this number will rise dramatically in the next quarter of a century (International Disability Foundation, 1998). It is estimated that between 1.3% and 3.5% of the population in the UK has a learning disability (Department of Health, 2007). The government strategy for people with a learning disability for the 21st century entitled 'Valuing People' defines learning disability as including the

involved in the care of people with a disability worldwide.

**2. Disability and oral health** 

services.

presence of:

**2.1 Disability in the UK** 

Jenny Gallagher and Sasha Scambler *King's College London Dental Institute* 

