Comparative Analysis of Dental Treatment for Children With and Without Special Healthcare Needs at Academic Dental Hospitals in South Africa.

Background: Children with special healthcare needs (CSHCN) experience higher unmet dental treatment needs than their healthy peers (NSHCN).

Aim: We compared dental treatment received by CSHCN and NSHCN at academic dental hospitals in South Africa (SA).

Design: Clinical records of 1-16-year-old children who had dental treatment under general anaesthetic (GA) between 2017 and 2023 were reviewed. Descriptive analyses were performed, and the Chi-square/Fisher's exact test used to analyse the categorical variables.

Results: Four hundred records (CSHCN: 116 [29%] and NSHCN: 284 [71%]) were analysed. The median age at assessment was 5 years (IQR: 3-6.5). CSHCN were older than NSHCN, (p < 0.001). More CSHCN (52.6%) than NSHCN (25.4%) were referred from primary health centres, (p < 0.001). Caries was the main dental diagnosis. Multiple extractions were done in 54.7% of CSHCN < 6 years and 52.8% of 6-11-year-old NSHCN. Restorative treatment was performed in 26.1% of 6-11-year-old CSHCN and 27.2% of NSHCN < 6 years.

Conclusions: Most of the CSHCN and NSHCN who needed GA were young with extensive caries. Treatment provided to both groups was primarily extractions, perhaps due to late presentation and limited resources. Timely preventative strategies for children at risk of caries could enhance oral health and reduce the burden of GA in SA.