Oral health needs and case mix complexity of adults with disabilities requiring special care dentistry: a retrospective hospital audit.

INTRODUCTION

Adults with disabilities may present with conditions that exacerbate symptoms of oral diseases, resulting in changes in behaviours and distress. Access to necessary oral healthcare is often available at various levels of the healthcare system, and the appropriate level of care may be stratified according to case complexity. This study was conducted in a tertiary-level centre for oral health that provides specialist-level care for adults with disabilities and special needs, often referred from primary care or other tertiary healthcare services.

METHODS

Analysis of patients' anonymised first visit hospital records from March 2022 to December 2024 included medical diagnoses, oral status, indication for the need for advanced pharmacological behavioural management (i.e., sedation, general anaesthesia), and written notes. Case mix complexity was scored through reviewer analysis of each record.

RESULTS

184 records were included in the analysis. The largest source of referrals was from tertiary medical services (43.9%), and the most common disability was that of mixed disability (34.8%). 33.2% of patients presented with active dental caries, and advanced pharmacological behavioural management was indicated in 37% of cases. 48.4% of cases were classified as Severe Complexity, and 10.9% as Extreme Complexity. The study also found indications that higher care needs were from patients referred from paediatric services and adults with intellectual disability.

CONCLUSION

Within this study population of patients attending tertiary oral health services, oral health needs and case complexity is high. The analysis of hospital records provides valuable insight for resource allocation and strategic initiatives. This provides supporting evidence to inform efforts aimed at improving integration of care pathways for these population segments.