Transitioning of special needs paediatric patients to adult special needs dental services

Abstract

Background: Special needs dentistry is in its infancy compared to other dental specialties. Continuity of care through transition from paediatric to adult dental care providers is unknown. This study seeks to determine the nature of transition practices adopted by paediatric and special needs (SN) specialists practising throughout Australia. Methods: A survey was sent to all paediatric and SN specialist dentists in Australia to determine the nature of current transition practices for paediatric SN patients in Australia. Two subsequent mail-outs were sent to non-responders. Results: Forty-nine specialist dentists registered across Australia completed the survey, of which 35 (71%) were paediatric dentists and 14 (29%) were SN dentists. Both paediatric and SN dentists treated patients over the age of 18. Of the total paediatric dentists who had transition discussions with their paediatric patients and their families, the majority (over 80%) discussed treatment options available as part of future oral care management. Paediatric dentists identified level of independence and financial situations as the most significant barrier for transition. Conclusions: Key factors exist that should be discussed with SN patients and their parents and/or guardians in order to enhance the prospect of sustained dental care into adulthood.

The Perception of Special Needs Dentistry amongst General Dentists within Western Australia, Australia

“…Patients whose special needs were more complex and fell outside the scope of general practice had traditionally referred to paedodontists [29,34], or Oro-Maxillofacial Surgeons [34] since children with specialist oral care needs were often treated for by paediatric dentists. If their access to oral care is to be assured as they move through adolescence to adulthood, this will require a transition to other oral health specialists skilled and trained in their management [34,59]. Today, in a country such as Australia, a clear treatment pathway is now available for patients with complex special needs under the auspices of Specialists in Special Needs Dentistry.…”

Association between disability status and dental attendance in Australia—A population‐based study

“…The oral healthcare system remains unsustainable, unaffordable, inequitable and nontailored to the healthcare needs of people with disability, consequently resulting in negative impact on continuity of care. 17,31 The Commonwealth Government has a key role in planning dental health services for people with disability due the current funding arrangements shared between federal and states and territory governments. 32 The recently introduced Child Dental Benefits Schedule (CDBS) increases access to dental care among children and adolescents in Australia through a comprehensive list of services:…”

“…However, a shortage of suitably qualified specialists in the workforce, and the concentration of specialists in major metropolitan cities persists. 17,39 Yet, in some situations, continuity of care is lost due to lack of appropriate transition TA B L E 3 Multivariable logistic regression models for the association between dental attendance and disability (n = 17 461) pathways. 17,29 An integrative team could help tackling the lack of resources and perhaps help the reduction of health expenditure.…”

“…In Australia, recent evidence from a population-based survey outlined the barriers in the transition process, from the perspective of both paediatric and Special Needs Dentists (SND) which included age, maturity, level of independence and financial constraints. 17 However, there are relatively little data in relation to transition care for adolescents and young adults with disabilities. 7,18 Adolescence is a tipping point as the lack of an inclusive dental system can establish long-term continuing trends of irregular dental attendance among individuals with disability.…”

Utilisation of dental services for people with special health care needs in Australia

“…In order to address this ongoing issue, Australia and New Zealand were amongst the first countries to establish special needs dentistry as a registrable dental specialty and, in doing so, recognise the growing group of individuals within our adult population with additional health care needs, and how this can impact on their oral health or ability to access health care [ 6 , 7 ]. Previously, many of these individuals were managed by paediatric dental specialists who continued to provide care to children with special needs [ 8 ]. Consequently, special needs dentistry has evolved to be defined as a speciality that “supports the oral health care needs of people with an intellectual disability, medical, physical or psychiatric conditions that require special methods or techniques to prevent or treat oral health problems, or where such conditions necessitate special dental treatment plans” [ 9 ].…”