Accuracy of estimation of dental treatment need in special care patients

Objectives: To assess the ability of carers and dental professionals to estimate treatment need in a group of children and adults with special needs. Method: A retrospective study of a series of 103 special needs patients who had received restorative dental treatment under general anaesthetic was undertaken. The initial reason for attendance and the time lapse between first symptoms and decision to consult were established. The parent or carer was asked to estimate treatment need and to assess the degree of discomfort suffered by the patient. The dentist evaluated treatment need by means of a pre-operative treatment plan. These results were compared to actual treatment performed. Results: Treatment need was severely underestimated by both carer and dentist. The degree of advanced pathology found in the population would suggest that pain suffered was also underestimated. Conclusions: Access of patients with special needs to dental care may be limited by the ability of their carers to evaluate their oral condition and/or by the persons’ inability to express their pain or discomfort.