Clinical Characteristics of Referred Patients Requiring Pharmacological Behavior Management in Special Care Dentistry （Part 2）：A Study on the Scope of Care Feasible at Community-Based Dental Institutions after Referral-Back

Abstract

Patients with disabilities who undergo dental treatment under pharmacological behavior management （PBM） are often referred back to their original dental institution after completion of treatment；however, the scope of dental care feasible at community-based institutions after referral-back has not been fully clarified. This study （Part 2） aimed to investigate, through a questionnaire survey of dental institutions referring patients to the Sakai City Dental Clinic for Severe Disabilities, the range of dental care that could be provided after referral-back based on self-assessment, and to identify challenges amid regional changes in care. Among 625 patients who received dental treatment under PBM between February 2018 and September 2023, responses were obtained from 423 referring dental institutions. The most common response indicated that only oral hygiene management could be provided after referral-back, while dental procedures involving tooth preparation or local anesthesia were recognized as difficult to perform at community-based institutions. In contrast, for patients with cerebral palsy, a relatively higher proportion of institutions reported being able to provide dental treatment including local anesthesia, suggesting differences according to disability characteristics. In conclusion, patients requiring PBM tended to be concentrated in specialized facilities, and regional transition after completion of treatment may not proceed smoothly. Strengthening behavioral support in community-based dental practices, providing training in sedation and restraint techniques, and establishing collaborative follow-up systems after referral-back are essential to promote regional transition of dental care for patients with disabilities.