Clinical Survey of Referred Patients Requiring Pharmacological Behavior Management in Special Care Dentistry （Part 1）：A Retrospective Analysis of 634 Cases at a Specialized Dental Clinic

Abstract

Dental treatment for patients with disabilities often requires pharmacological behavior management （PBM）, such as intravenous sedation or general anesthesia, because of difficulties in behavioral control and medical safety concerns. Specialized dental facilities therefore play an important role in providing PBM-based care. The aim of this study was to clarify the clinical characteristics and referral patterns of patients referred to a specialized dental clinic for individuals with disabilities. We retrospectively analyzed 634 patients who visited the Sakai City Dental Clinic for Severe Disabilities for the first time or as re-referrals between February 2018 and September 2023. Data regarding patient demographics, primary disability, referring institutions, and referral purposes were extracted from medical records. PBM was required in 98.6％ of patients. Intellectual disability was the most common primary diagnosis （62.0％）, and males accounted for 66.1％ of the study population. The largest age group was children under 10 years of age, followed by patients in their 20s. More than half of the patients were referred from community-based dental clinics. The most frequent referral purpose was general dental treatment. However, among patients with cerebral palsy, requests for surgical procedures, such as extraction of impacted teeth and minor oral surgery, were more common. Significant associations were observed between referral purposes and primary disability, age group, and type of referring institution. In conclusion, the majority of patients referred to our clinic required PBM-based dental treatment, and referral patterns varied according to patient characteristics and referring institutions. This clinical survey highlights the central role of specialized dental clinics in providing PBM-based care for patients with disabilities and provides fundamental data for understanding current referral trends.