dental caries remains today the most common infectious disease which affects most of the population regardless of age . caries prevalence is high , and oral hygiene is not good , in poor and developing countries as well as albania . several studies have noted that children with disabilities have higher levels of caries , periodontal diseases , and much higher proportion of untreated lesions but less treatment than children without disabilities . oral health of these children depends on age , type of disability , severity of impairment and living conditions . other factors that cause high caries prevalence , poor oral hygiene and high proportion of untreated lesions are parents and caregivers lack of information , knowledge and care about oral health of disabled children ( 1 ) , their socio - economic status and education level . many individuals with special needs may have great limitations in oral hygiene performance due to their manual dexterity , sensory and intellectual disabilities ( 5 ) , and so are prone to poor oral health . different studies carried out for caries prevalence at disabled children comparing that without disabilities shows contradictory results . the aim of this study is to determine the caries prevalence and oral hygiene status at children with various types of disabilities attending different schools for disabled children in albania . the study population consist of 638 children aged 3 - 18 years old form 9 special schools of albania located at six ( 6 ) different cities , the survey sample comprise 599 ( 94% ) , six ( 6 ) percent were absent during the examination sessions . informed consent of parents or guardians and school authorities was obtained before the subjects were included in the study . children that were not cooperative or whose parents have not given consent are excluded from the study . clinical examinations were carried out at schools , in a school medical room or classroom with natural light . the examinations were carried out with the aid of an ordinary mouth mirror and a who ball and cpi- tip probe . the data for each subject were recorded on the standard who , however several changes were made and special survey form has developed . children are divided in different groups according type of disability . for each individual dental caries and treatment need is assessed for primary and permanent dentition using deft , defs , dmft , dmfs indices . oral hygiene status is calculated using the simplified oral hygiene index ( ohi - s ) of greene and vermillion . fair when it was 1.213.1 and  poor when it was 3.11 up to 6 . children are visually examined for dental hygiene and by passing cpi probe parallel to the buccal and lingual surfaces for the presence of plaque . chi square test and fisher s exact test were used to compare the proportions of categorical variables . on the other hand , anova ( analysis of variance ) and kruskal - wallis test were used to compare mean values of numerical variables between disability groups . ninety - four percent ( 94% ) or 599 of 638 subjects responded to the call for screening . the mean age of population is 12.00(6.00 ) years old ( table 1 ) . according of type of disability 84 ( 1.8% ) subject had autism specter disorder , 217 ( 36.2% ) are mental retarded , 26 ( 4.3% ) had cerebral palsy , 147 ( 24.5% ) are deaf - mute , 34 ( 5.7% ) have down syndrome , 91 ( 15.2% ) are blind ( table 1 ) . seventy - two ( 72% ) had caries at primary dentition ( tab 2 ) . down syndrome group has the lowest caries prevalence ( 54.5% ) and cerebral palsy group the highest ( 83.3% ) at primary dentition ( table 2 ) . the mean deft of total sample was 3.43.5 while the mean defs was 7.0 9.1 ( table 3 ) . there is significant statistical difference between types of disability for deft index ( deft p0.029 , defs p0.066 kruskal - wallis test ) ( tab3 ) . children with cerebral palsy has the highest deft = 4.54 and children with down syndrome deft = 1.92.7 the lowest value ( table 3 ) . number and percentage of participants by disability type and age group caries prevalence at primary and permanent dentition by type of disability mean values of dmf(t ) , dmf(s ) , def(t ) and def(s ) by disability type caries prevalence at permanent dentition is 85.3 % ( tab 2 ) , children with autism specter disorder has the lowest caries prevalence ( 60.0% ) and blind children has the highest ( 91.0% ) ( table 2 ) . the mean dmft for the total sample is 4.94.6 while the mean dmfs is 9.612.9 ( table 3 ) . mentally retarded children has the highest dmft/ dmfs index ( dmft=5.85.2 , dmfs=13.217.3 ) and children with autism specter disorder the lowest dmf / dmfs index ( dmft=2.63.2 , dmfs=4.57.8 ) ( tab 3 ) . there is significant statistical difference between disability types for both dmft / dmfs index ( p0.001 , kruskal - wallis test ) ( table 3 ) . the mean ohi - s index of total population is 1.9 ( table 4 ) , children with cerebral palsy has the best oral hygiene with mean ohi - s index and deaf - mute children the worst oral hygiene with mean ohi - s index 2.25 ( table 4 ) . there is statistical significance difference among types of disability ( p0.001 , chi square test ) for ohi - s index ( tab 4 ) . forty- three ( 43.2% ) of total sample has good oral hygiene , 49.4% fair and 7.4% bad oral hygiene ( table 4 ) . according to recent literature , individuals with disability have poor oral health and high treatment need in comparison with people without disability . in our study dental caries prevalence according dentition is 85.3% ( n=446 ) for permanent dentition ( table 2 ) and 72% ( n=232 ) for primary dentition ( table 2 ) . our data show high caries prevalence for disabled children , comparing to other studies we find that our values are higher than values showed by ( 7,8,13,14 ) , similar with ( 15,16,17 ) and lower than ( 18,19,20 ) . our results are similar to those found by ( 21 ) at a study conducted at tirana , albania with 12 years old children without disabilities and higher than values find by ( 22 ) for caries prevalence at children without disabilities aged 7 - 15 at tirana , albania . mean and detailed caries prevalence and indices are higher than results found at children without disability ( 21,22 ) , lower than that reported by ( 7,8 , 14 , 17 , 23 ) , and similar ( 13 , 19,24,25 ) . the reasons why we have such a variance of results is because of different types of disability , age group and geographical extension selected by authors . according of type of disability our results are similar with those found by ( 7,11,13,14,20 ) for permanent dentition . at primary dentition our results are similar with those found by ( 14 ) and contrary to those found by ( 13,17,20,26 ) . there is significant statistic difference for dmft and deft index according of type of disability , these result are confirmed by ( 13 , 19 , 20 , 28 ) but contrary to other authors such as ( 13,17,25 ) which did nt find statistical significance difference between types of disability . oral hygiene status of children with disability is not good and this is in accordance with other studies ( 7,8,11,14,15,19,22 ) . our mean ohi - s index is 1.91 ( table 4 ) which is lower than that found by ( 19 , 22 ) . according of type of disability cerebral palsy and autistic specter disorder has the best oral hygiene and deaf - mute group the worst these results are similar with those found by ( 11 , 20 ) although our values are higher and contrary to those found by ( 14 ) . good  ( 43.2% ) and  bad  ( 7.4% ) ( tab 4 ) , these results are similar with that found by ( 7 ) but contrary to that found by ( 8,28 ) . there is statistical significance difference among types of disability ( p0.001 , anova test , tab 4 ) which is in accordance of study carried out by ( 28 ) , other authors such as ( 17 ) . a very high caries experience and poor oral hygiene status demands immediate attention to increase efforts for prevention and treatment of oral diseases in these special groups of children . from the study result that children with disability has high caries prevalence and bad oral hygiene.childrens with disability needs more dental treatment and care from their parents and caregivers . 
  from the study result that children with disability has high caries prevalence and bad oral hygiene . children s with disability needs more dental treatment and care from their parents and caregivers .