Sairi Mohamad Noor, Mohd Nor Nor Azlida, Kherul Anuwar Ainol Haniza, Mohamed Rohani Maryani, Ahmad Fisal Aisyah
Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, MYS.
Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, MYS.
Cureus. 2025 Jul 26;17(7):e88796. doi: 10.7759/cureus.88796. eCollection 2025 Jul.
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.
背景与目的 满足有特殊医疗需求（SHCN）人群的口腔健康需求变得越来越迫切。然而，关于这一人群的研究数据往往有限，尤其是在成年人和老年人中。因此，本研究旨在评估前往马来西亚一家牙科医院就诊的成年SHCN患者的口腔健康状况，确定相关因素，并将他们的疾病负担与全国患病率进行比较。
方法 这是一项横断面研究，涉及对2021年1月至2023年12月期间在马来西亚一家牙科医院接受治疗的成年SHCN患者进行回顾性数据分析。收集了社会人口学特征、医疗状况、残疾类型、复杂程度、龋齿状况和牙周健康等方面的数据。分别使用国际龋病检测与评估系统（ICDAS）和基本牙周检查（BPE）指数来测量龋齿和牙周疾病。此外，从2020年马来西亚全国口腔健康成人调查中提取了一般成年人群的口腔健康数据。使用描述性分析和多变量分析对数据进行分析。
结果 共有513名成年患者纳入分析。超过一半（n = 271，52.8%）为男性，平均年龄为51.04岁（标准差：±21.36）。SHCN组的龋齿患病率显著低于全国平均水平[n = 370，（72.1%） vs. n = 14,241，（85.1%）]。然而，SHCN组留存的天然牙比一般人群少，平均分别为22.6颗和24.4颗。尽管一般人群中牙周不健康的总体患病率更高[n = 15,814（94.5%） vs. n = 418（81.5%）]，但SHCN组牙周袋的患病率显著更高[n = 6,392（38.2%） vs. n = 244（47.6%）]。在回归模型中，年龄仍然是龋齿的一个重要预测因素。牙周疾病在老年人以及患有多种疾病或残疾的人群中更为常见。此外，复杂度评分为中等的患者发生牙周袋（BPE评分≥3）的风险显著更高（p = 0.032）。
结论 SHCN成年人口腔疾病的患病率总体上与全国平均水平相当，晚期牙周疾病负担明显更高，总体牙齿留存率更低。年龄、多重残疾和更高的复杂程度与该人群不良的口腔健康状况相关。这些发现强调了需要通过多部门合作加强和扩大针对这一弱势群体的口腔医疗服务。
