The Oral Health Status of Adults With Special Healthcare Needs: A Hospital-Based Study and Comparative Analysis With National Data

Background and objective There is a growing need to address the oral health of individuals with special healthcare needs (SHCN). However, research data on this population is often limited, particularly among adults and the elderly. Hence, this study aimed to assess the oral health status of adult SHCN patients attending a Malaysian dental hospital, identify associated factors, and compare their disease burden with the national prevalence. Methodology This was a cross-sectional study involving retrospective data analysis of adult SHCN patients who received treatment at a Malaysian dental hospital between January 2021 and December 2023. Data on sociodemographic characteristics, medical conditions, disability types, complexity level, dental caries status, and periodontal health were collected. Dental caries and periodontal disease were measured using the International Caries Detection and Assessment System (ICDAS) and Basic Periodontal Examination (BPE) indices, respectively. Additionally, oral health data from the general adult population were extracted from the Malaysian National Oral Health Adult Survey 2020. The data were analyzed using descriptive and multivariate analyses. Results A total of 513 adult patients were included in the analysis. More than half (n = 271, 52.8%) were male, with a mean age of 51.04 years (SD: ±21.36). The prevalence of dental caries was significantly lower in the SHCN group compared to the national average [n = 370, (72.1%) vs. n = 14,241, (85.1%)]. However, the SHCN group had fewer remaining natural teeth than the general population, with a mean of 22.6 and 24.4, respectively. Although the general population had a higher overall prevalence of unhealthy periodontium [n = 15,814 (94.5%) vs. n = 418 (81.5%)], the SHCN group exhibited a significantly higher prevalence of periodontal pockets [n = 6,392 (38.2%) vs. n = 244 (47.6%)]. Age remained a significant predictor of dental caries in the regression model. Periodontal disease was more common among older adults and those with multiple medical conditions or disabilities. Additionally, patients with a moderate complexity score had a significantly higher risk of developing periodontal pockets (BPE score ≥3) (p = 0.032). Conclusions The prevalence of oral disease among adults with SHCN was generally comparable to the national average, with a notably higher burden of advanced periodontal disease and lower overall tooth retention. Age, multiple disabilities, and higher complexity levels were associated with poor oral health status in this population. These findings underscore the need to strengthen and expand oral healthcare delivery through multi-sectoral collaboration for this vulnerable group.