Accessibility of Special Care Dentistry Across Countries: A Scoping Review

Abstract

Introduction: People with special care needs often face significant barriers in accessing dental care due to physical and cognitive limitations, leading to high rates of dental issues like caries. Despite the growing recognition of these challenges, unmet dental care needs remain prevalent. This review aims to explore the global landscape of special care dentistry to identify gaps and opportunities for improving dental services for this population. Methodology: A systematic search was conducted across three online databases—PubMed, Embase, and Scopus—to identify relevant articles from their inception through May 2024. Reference lists of the selected studies were also screened for additional sources. A thematic synthesis approach was applied to derive both descriptive and analytical themes. The scoping review was guided by the Arksey and O’Malley framework to examine the scope and nature of studies and documents related to dental care for individuals with special care needs. Furthermore, a Google search was performed to include accessible theses and official government documents from various countries. Results: A total of 49 studies from 11 countries were reviewed, all centered on providing dental care for people with special needs. The analysis revealed three main themes: Human resources, care delivery model, and management. Within these, nine subthemes emerged: Mid-level oral care providers, dentists, special care dentistry as a specialty, tele-dentistry, mobile dentistry, hospital care, levels of healthcare provision, financial support, and education. These themes and subthemes highlight essential areas for enhancing services for those people. Conclusions: A holistic approach is essential to enhance dental care for people with special needs (PWSNS). Critical strategies, including the involvement of mid-level oral care providers, the adoption of tele-dentistry and mobile units, and the availability of hospital-based services for complex cases, are crucial. To truly transform care for those people, each country must adapt these strategies to its specific context, aligning resources and policies to create an inclusive, accessible, and effective system.