A vital communication link between two health professionals is through referral, which can be defined as ‘the act of directing someone to a different place or person for information, help, or action, often to a person or group with more knowledge or power’. Furthermore, practitioners may not be aware of the services provided by an ISNU or the referral criteria involved. 9 Dental and other health professionals are uncertain as to the profile of patients that should be referred to the specialist in a dental clinic that provides dental services for this cohort. Special needs patients in the hospital are treated in the ISNU clinic or day surgery unit where treatment is conducted under general anaesthesia (GA).Įvidence has shown not all dentists are able to identify different special needs groups, which may indicate poor understanding about this recent discipline. 8 Dental treatment for patients with special needs is carried out in the integrated SND unit (ISNU) either directly within the hospital itself or via domiciliary (DOM) services. 2, 6, 7 In Victoria, the Royal Dental Hospital of Melbourne (RDHM) is the largest public dental facility that strives to improve accessibility for people with special needs under the auspices of the Dental Health Services Victoria (DHSV) and employs four SND specialists. Since the establishment of SND as a dental specialty in Australia almost 12 years ago, 15 specialists across four Australian states (Victoria, N = 7 South Australia, N = 4 New South Wales, N = 2 and Queensland, N = 2) have registered with the Australian Health Practitioner Regulation Agency.

Historically, the provision of dental care for special needs patients has been conducted on an ad hoc basis by general dental practitioners, 4 paediatric dentists 5 and to a variable degree by oral and maxillofacial surgeons and oral medicine specialists. 2 SND specialists have particular expertise in providing appropriate expert dental care plans that best address a patient's need based on a comprehensive analysis of their health conditions and other underlying factors. 1 One characteristic that sets this specialty apart from most other branches of dentistry is that it involves patients with varying degrees of difficulty in dental management arising from levels of dependency, cooperation, communication, cognitive capacity, health conditions and social support requirements.

Special Needs Dentistry (SND) is the branch of dentistry concerned with the oral health of people adversely affected by disability (intellectual and physical), and medical or psychiatric conditions.

integrated special needs dentistry unit.

ConclusionsĪ diverse pattern of SND patients was referred to the ISNU with a majority of referrals having no specific referral reason cited, suggesting poor quality of referrals. The reasons for referral included lack of compliance (27.2%), further management due to multiple medical conditions or GA services required (9.9%), or for multiple other reasons (62.9%). A referral may have specified more than one special needs condition with the most common category being those who were medically compromised (81.7%). Six-hundred and eighty-eight referrals were received with the majority for the OP clinic (68.3%), followed by DOM (22.4%) and GA services (9.3%) (χ 2 = 360.2, P < 0.001). MethodsĪll referrals received over a 6-month period (1 January–30 June 2013) by the integrated SND unit (ISNU) were reviewed prior to allocation to the outpatient clinic (OP), domiciliary (DOM) or general anaesthetic (GA) services.

The purpose of this study is to identify, via referrals received, the profile of patients and quality of referrals at the largest public SND unit in Victoria, Australia. Special Needs Dentistry (SND) has been recognized as a dental specialty in Australia since 2003 but there have been no studies addressing the profile of patients for specialist care.

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