Special care dentistry in a charity clinic: Demographic analysis and barriers to care in Singapore

Abstract

Objective:Geriatric and special care dentistry (GSD) aims to improve oral health of seniors or adults disabilities facing barriers to care. This is coherent with the philosophy of “compassion relief.” Tzu Chi Singapore's Free Clinic exemplifies this through promoting health via various avenues to reach out. This article aims to provide a demographic analysis of patients with special care needs (PSCN), including age, gender, race, medical diagnoses, and treatment rendered. The patients were appraised on their complexity with the British Dental Association case mix model.Materials and Methods:PSCN seen by a dentist in Tzu Chi Singapore from November 2016 to December 2017 were recorded. The profiling of patients was done retrospectively.Results:Fifty-five dental PSCN were treated over 82 visits. 58.2% were seen in the free clinic, 27.3% in nursing homes, and 14.5% in oral health day programs for adults with intellectual disability. Their average age was 61.2 years, and the clinic was attended by patients of different races. Their medical profiles were grouped into seven categories, and the average case mix total banded score was 21.6, indicating that the average patient had “severe complexity”. A few themes relevant to Singapore were discussed, such as specialist GSD clinics, accessing dental services, socioeconomic status, state versus charity healthcare, and provision of future GSD services.Conclusions:Charity dental services such as free clinic can capture a niche of complex patients who may become marginalized in an established public healthcare.

Disability and oral health in the Association of Southeast Asian Nations - A survey for conceptualisation and development

“…It was also raised as an area of collaboration for the ASEAN DOH community (Table 6). Comparing the financial structures, such as state-funded or privately-sustained programmes, health literacy levels, 25 and varying stages of health system development, the limited literature imply there could be considerable difficulties when implementing a specialty such as SCD in the public health system. 14,16,[25][26][27] The extent to which specialty recognition can efficiently improve the oral health status across cohorts of PWD is often debated.…”

Pessoas Com Deficiência: Percepção De Seus Cuidadores Quanto Ao Atendimento Odontológico

“…A relação entre profissional, paciente e família/cuidador deve ser genuína para que se tenha um bom resultado de tratamento. 23 Criar estratégias que realizem tratamentos de forma mais ampla, dando valor a implicação destes problemas no contexto de vida da família é uma ação que valoriza o aspecto humano. 24 Conhecer as alterações do paciente, tanto pelo profissional quanto pelo cuidador é o que trará uma rotina específica e o sucesso do tratamento, assim como na prevenção de futuras doenças bucais.…”

Conscious sedation service for geriatric and special-care dentistry: A health policy brief

“…The British Dental Association case mix complexity index noted the group requiring behavioural management had a higher overall complexity. 22,23…”

“…The British Dental Association case mix complexity index noted the group requiring behavioural management had a higher overall complexity. 22,23 Of 85 PSCN requiring behavioural management, 41.2% coped well with behavioural techniques, including tell-showdo, graded exposure, distraction techniques and light clinical holding. A fifth (21.2%) had dental treatment completed with significant difficulties, notably physical restraint, and would have been better managed with CS if it had been available, and 23.5% were unable to complete their dental treatment without any pharmacological management (CS or GA included).…”

“…6,7 The need for CS for GSD As a tertiary centre, Singapore' s only GSD centre sees PSCN who are medically complex and find more difficulty cooperating. 22 The PSCN who require behavioural management are treated either under LA or under GA. The collated data of PSCN seen by a special-care dentist in 2017 revealed that 53.1% required varying levels of behavioural management ( Table 1).…”