Keywords
care provider - dental care - obstacles - oral health - special needs
Introduction
The American Association of People with Disabilities defines special health care needs
as “any developmental, physical, sensory, mental, behavioral, cognitive, or emotional
impairment or limiting condition that requires medical management, health care intervention,
and/or use of specialized services or programs.”[1] Around 500 million individuals worldwide are suffering from one or more mental,
physical, or sensory disabilities for which special health care facilities are indispensable.[2] It has been reported that in Saudi Arabia specifically, one million individuals
are disabled and require special health care needs.[3]
Disabilities can be acquired, congenital, or have developmental origin, with their
major risk factors being trauma, disease, and environmental issues. These disabilities
have serious effects on the routine activities of individuals. Health care professionals
must possess adequate knowledge and awareness to provide adequate health care facilities
to disabled individuals. It is indispensable for caregivers of disabled individuals
to have keen attention and awareness about all the available facilities and possess
knowledge about their use.[4]
Among various health care services available, oral health care has an important role.
Unsatisfied dental requirements are because of the complexity of the status of special
health care needs.[5] Risk of unmet needs increases in children suffering from more relentless conditions.[6]
[7] There have been various reports of structural and motor barriers, including the
cooperation level of children, access to dental treatment, expertise and experience
of dentist, transportation issues, treatment cost, as well as dependency on and communication
with the caregiver regarding the need for oral health care.[8]
[9] It is a very common observation that oral health care takes a backseat compared
with other health requirements among parents and caregivers.[10]
[11]
Various studies have been conducted in Saudi Arabia with the primary intention of
understanding the obstacles encountered by disabled individuals requiring dental care.[12]
[13] Saudi Arabia is well-known for its diversity in public health and socioeconomic
status among the population across cities and areas. Hence, investigating the barriers
encountered by both patients seeking oral health care treatment and dental professionals
offering services to disabled individuals in different parts of Saudi Arabia is vital.
The present study was predominantly conducted to identify the actual barriers faced
by disabled patients in the dental care segment by means of questionnaires provided
for both dental practitioners and disabled patients or their guardians—with this,
a solution could be obtained to resolve or improve the problems encountered by both
dental practitioners and disabled patients in the Jazan region of Saudi Arabia.
Materials and Methods
The present cross-sectional study involved two participant groups. The first group
consisted of 100 individuals, including 96 parents of patients with special needs
and 4 patients who were able to respond independently. The second group consisted
of 60 dental professionals, comprising dental interns, general dentists, and specialists
from January 2022 to March 2022. The questionnaire used in this study was developed
by the authors based on an extensive review of the literature and adaptation of validated
instruments. The self-administered structured questionnaire helped assess the demographic
variables and information regarding problems in managing the treatment of disabled
children among both parents and dental professionals.
The validity of the questionnaire was assessed and found to be appropriate (α = 0.85). A pilot test was conducted with 10 participants (5 from each group) to ensure
clarity and feasibility. Content validity was assessed by three experts in pediatric
and public health dentistry. The study was conducted in accordance with the Declaration
of Helsinki and approved by the institute's local ethics committee (REC-43/07/155).
An informed written consent from all subjects was obtained prior to their enrolment
in this study and the demographic data collected included age, gender distribution,
and marital status of the participants.
In total, 100 individuals, including parents and patients of both genders, belonging
to the Jazan region of Saudi Arabia participated in the study. The second group included
dental professionals who were consultants or dental practitioners working in the Jazan
region, as well as interns and dental undergraduate students of a medical university
in Jazan, Saudi Arabia. To analyze the obstacles related to the dental treatment of
disabled children, two different questionnaires were prepared, one for the parents
and the other for dental professionals.
A questionnaire containing 19 well-constructed questions was framed and posed to dental
professionals regarding the various conditions that could influence the management
of a disabled child in a dental setup and the kind of special measures they take to
tackle these patients. The second questionnaire containing 24 well-constructed questions
was asked to parents and patients regarding the numerous factors that impact the management
of dental problems and the types of obstacles faced while getting their disabled child
treated. The response to all these questions from both questionnaires was recorded.
The questionnaire, besides recording the demographic characteristics of both parents
and dental professionals, also had a “yes/no” option or other relevant options according
to each question.
The data thus obtained was subjected to statistical analysis using IBM SPSS version
20.0 software. Descriptive statistics, in other words, frequencies and percentages,
were computed, and the comparative analysis was done using the chi-square statistical
analysis.
Results
Sixty dental professionals participated in the study, out of which a maximum of 60%
belonged to the 20- to 25-year age group. Note that 93.3% belonged to the Saudi region,
of which 78.3% were from the Jazan area. Also, 61.7% were females and 38.3% were males.
Among dental professionals, a maximum of 56.7% were dental interns, followed by consultants,
general dentists, and students. A maximum of 32% had less than 5 years of experience
([Table 1]). A well-framed questionnaire comprising 19 questions was posed to dental professionals
regarding the obstacles faced while treating individuals needing special health care
requirements.
Table 1
Demographic variables
|
Parameters
|
Frequency
|
Percentage
|
|
Nationality
|
Non-Saudi
|
4
|
6.7
|
|
Saudi
|
56
|
93.3
|
|
Age group
|
20–25 y
|
36
|
60.0
|
|
26–30 y
|
7
|
11.7
|
|
31–35 y
|
9
|
15.0
|
|
36–40 y
|
5
|
8.3
|
|
> 40 y
|
3
|
5.0
|
|
Gender
|
Female
|
37
|
61.7
|
|
Male
|
23
|
38.3
|
|
Province
|
Aseer
|
4
|
6.7
|
|
Dammam
|
5
|
8.3
|
|
Jazan
|
47
|
78.3
|
|
Makkah
|
1
|
1.7
|
|
Najran
|
1
|
1.7
|
|
Riyadh
|
2
|
3.3
|
|
Educational level
|
Dental intern
|
34
|
56.7
|
|
Dental specialist/Consultant
|
16
|
26.7
|
|
Dental student
|
2
|
3.3
|
|
General dentist
|
8
|
13.3
|
|
How many years did you practice dentistry?
|
< 5 y
|
32
|
|
|
5–10 y
|
12
|
|
|
> 10 y
|
16
|
|
|
Total
|
60
|
100
|
While a maximum of 61.7% of dental professionals encountered disabled children during
their dental practice and almost 33.3% received specialized training, 75% of dental
professionals were educated in managing disabled patients, but 70% still lack the
specialist referral circle among them. It is also reported that only 26.7% of specialized
dentists are available for managing disabled patients. Around 68.3% ably provide required
facilities such as parking and wheelchairs for the disabled, but 73.3% do not come
equipped with special facilities, including signboards, special toilets, trained associates,
adequate equipment, pharmacy, etc. Lack of facilities, insufficient information, and
inadequate training have been quoted as major obstacles for managing disabled patients
by 25% of dental professionals ([Table 2]).
Table 2
Response to questionnaire
|
Questionnaire
|
Frequency
|
Percentage
|
Statistical analysis
|
|
Question
|
Option
|
Chi-square
|
p-Value
|
|
Do you have disabled person among your relatives?
|
No
|
39
|
65.0
|
2.09
|
0.041*
|
|
Yes
|
21
|
35.0
|
|
Any previous experience with disabled patients?
|
No
|
23
|
38.3
|
2.910
|
0.051*
|
|
Yes
|
37
|
61.7
|
|
Did you attend any course or workshop related to disabled patients (whether how to
deal, communicate, or treat them)?
|
No
|
40
|
66.7
|
1.991
|
0.021*
|
|
Yes
|
20
|
33.3
|
|
Have you been educated or shown how to handle and treat disabled patients?
|
No
|
15
|
25.0
|
1.908
|
0.011*
|
|
Yes
|
45
|
75.0
|
|
Is there any specialized dentist in treating disabled patients at your workplace?
|
No
|
44
|
73.3
|
1.008
|
0.012*
|
|
Yes
|
16
|
26.7
|
|
Do you have adequate consultation network between different specialties at your workplace
Including general medicine?
|
No
|
42
|
70.0
|
0.990
|
0.031*
|
|
Yes
|
18
|
30.0
|
|
Do you have separate parking for disabled patients?
|
No
|
19
|
31.7
|
1.118
|
0.012*
|
|
Yes
|
41
|
68.3
|
|
If the answer is yes, then how many disabled parking spaces do you have?
|
1.00
|
4
|
6.7
|
2.007
|
1.781
|
|
2.00
|
11
|
18.3
|
|
3.00
|
1
|
1.7
|
|
4.00
|
1
|
1.7
|
|
Are they close to the entrance door or not?
|
No
|
19
|
31.7
|
2.551
|
0.041*
|
|
Yes
|
35
|
58.3
|
|
Is there proper access for disabled patients to your workplace (wheelchair, climbing
platform, wide doors, etc.)?
|
No
|
14
|
23.3
|
2.771
|
0.001*
|
|
Yes
|
46
|
76.7
|
|
Do you have signage banners (written in both alphabet and braille alphabet), which
explain directions, different departments, and biohazard warnings at your workplace?
|
No
|
44
|
73.3
|
2.413
|
0.023*
|
|
Yes
|
16
|
26.7
|
|
Do you have properly prepared waiting area for disabled patients?
|
No
|
39
|
65.0
|
2.223
|
0.051*
|
|
Yes
|
21
|
35.0
|
|
Is there specially prepared toilet setting for disabled patients at your workplace?
|
No
|
35
|
58.3
|
1.993
|
1.08
|
|
Yes
|
25
|
41.7
|
|
Do you have adequately trained personnel to communicate and deal with disabled patients
at your workplace (such as person who knows sign language, etc.)?
|
No
|
50
|
83.3
|
2.331
|
0.041*
|
|
Yes
|
10
|
16.7
|
|
Is there adequate equipment and facilities to treat disabled patients at your workplace?
|
No
|
43
|
71.7
|
2.371
|
0.026*
|
|
Yes
|
17
|
28.3
|
|
Do you have nearby pharmacy where patients can get their prescribed medication?
|
No
|
36
|
60.0
|
3.012
|
0.032*
|
|
Yes
|
24
|
40.0
|
|
Did you refuse treating disabled patients due to lack of facilities, information,
or training?
|
No
|
32
|
53.3
|
2.913
|
1.61
|
|
Yes
|
28
|
46.7
|
|
If the answer is yes, which one created the greatest obstacle in treating disabled
patient (more than one option can be selected)?
|
Inadequate training
|
3
|
5.0
|
1.112
|
1.718
|
|
Insufficient information
|
3
|
5.0
|
|
Lack of facilities
|
6
|
10.0
|
|
Lack of facilities, Inadequate training
|
6
|
10.0
|
|
Lack of facilities, Insufficient information, Inadequate training
|
15
|
25.0
|
|
If you are working in private clinic is there any cost difference between treatments
provided to disabled patients and other patients
|
No
|
34
|
56.7
|
2.17
|
0.002*
|
|
Yes
|
12
|
20.0
|
Note: Values which are in bold or with Asterix are the ones which shows significance
difference statistically between opinion of that question.
A questionnaire with 24 well-defined questions including queries about obstacles encountered
while getting their disabled children treated for dental needs, proved handy in understanding
the demographic characteristics of parents of disabled children. Among the parents
of disabled children, 58% belonged to the rural area, 98% were from Saudi, and 58%
of them were females, with 40% of them having a secondary level of education. Almost
48% of the patients were at the primary level of education ([Table 3]).
Table 3
Demographic variables: parents
|
Parameters
|
Frequency
|
Percentage
|
|
Parent
|
96
|
96.0
|
|
Patient
|
4
|
4.0
|
|
Nationality
|
Non Saudi
|
2
|
2.0
|
|
Saudi
|
98
|
98.0
|
|
Place of residence
|
City
|
33
|
33.0
|
|
Other
|
1
|
1.0
|
|
Rehabilitation
|
1
|
1.0
|
|
Residence
|
7
|
7.0
|
|
Village
|
58
|
58.0
|
|
Gender
|
Female
|
58
|
58.0
|
|
Male
|
42
|
42.0
|
|
Educational level of patient
|
Intermediate
|
1
|
1.0
|
|
Primary
|
48
|
48
|
|
Under school age
|
33
|
33.0
|
|
Uneducated
|
17
|
17.0
|
|
University
|
1
|
1.0
|
|
Educational level of parent
|
Diploma
|
7
|
7.0
|
|
Intermediate
|
10
|
10.0
|
|
Primary
|
14
|
14.0
|
|
Secondary
|
40
|
40.0
|
|
University
|
29
|
29.0
|
|
Total
|
60
|
100
|
A maximum of 60% of the patients were physically disabled, with 86% bearing congenital
anomalies. Close to 43% suffered from dental problems, the most common of which was
dental caries (75%). Parental reports showed that 24% of patients were under medical
treatment while 97% of patients still needed facilities during travel.
A maximum of 48% reported that the dental problems are not linked to the use of medication,
while 21% felt that it might be because of excessive salivation. Problems with maintaining
oral health were a common complaint in 62% of the population, out of which 49% felt
that the methodology of brushing was the root cause of dental problems. While 46%
sought the help of dental clinics for treatment, 32% preferred government clinics.
Though 33% faced no problems regarding hospital facilities, 27% encountered problems
with appointment reschedules, and 22% reported long waiting queues in dental clinics.
Fortunately, 68% were never refused dental treatment and 64% never faced issues communicating
with the dentist. Few parents mentioned lack of equipment as a major difficulty in
getting treated but a majority of the parents were satisfied with the facilities available
and with the way patients were managed by dental professionals, but their only obstacles
were treatment cost (29%) and the fear (22%) of getting treated ([Table 4]).
Table 4
Response to questionnaire
|
Questionnaire
|
Frequency
|
Percentage
|
Statistical analysis
|
|
Question
|
Option
|
Chi-square
|
p-Value
|
|
What is the type of disability?
|
Attention deficit hyperactivity disorder
|
3
|
3.0
|
2.221
|
1.617
|
|
Auditory
|
1
|
1.0
|
|
Autism
|
2
|
2.0
|
|
Down's syndrome
|
1
|
1.0
|
|
Deaf
|
2
|
2.0
|
|
Hyperactivity disorder
|
2
|
2.0
|
|
Mental
|
39
|
39
|
|
Physical
|
60
|
60
|
|
Visual
|
7
|
7
|
|
Is the current disability? (congenital disability, disability resulting from injury)
|
Congenital disability
|
86
|
86.0
|
1.117
|
0.046*
|
|
Disability resulting from injury
|
14
|
14.0
|
|
Do you suffer from any other health problems?
|
No
|
76
|
76.0
|
1.006
|
0.037*
|
|
Yes
|
24
|
24.0
|
|
Do you see a doctor about disability on an ongoing basis?
|
No
|
18
|
18.0
|
2.551
|
0.002*
|
|
Yes
|
82
|
82.0
|
|
Does the patient always need facilities when traveling?
|
No
|
3
|
3.0
|
1.415
|
0.0001*
|
|
Yes
|
97
|
97.0
|
|
Have you ever had any problems with your teeth or mouth? (Yes, No)
|
No
|
37
|
37
|
1.427
|
1.499
|
|
Yes
|
43
|
43
|
|
If the answer is yes, choose the appropriate one (Swelling, pain, caries, inflammation
in the gums, fever in the mouth
|
Caries
|
75
|
75
|
1.514
|
0.998
|
|
Pain
|
45
|
45
|
|
Fever in the mouth
|
9
|
9
|
|
Swelling
|
19
|
19
|
|
Do you have oral problems as a result of your use of disability medications? (Yes,
No
|
Do not use medication
|
43
|
43.0
|
2.271
|
1.881
|
|
No
|
48
|
48.0
|
|
Yes
|
9
|
9.0
|
|
If the answer is yes, choose the appropriate one (dry mouth, heat in the mouth, change
in taste, stomach reflux, excessive salivation)
|
Dry mouth
|
2
|
2.0
|
0.991
|
0.042*
|
|
Excessive salivation
|
21
|
21.0
|
|
Heat in the mouth
|
2
|
2
|
|
Stomach reflux
|
1
|
1.0
|
|
Did you have difficulty in caring for and maintaining your teeth?
|
No
|
38
|
38.0
|
2.298
|
0.051*
|
|
Yes
|
62
|
62.0
|
|
If the answer is yes, what are the reasons for the difficulties you encountered? (difficulty
with the way the brush is used, difficulty in finding a suitable brush, difficulty
in maintaining brushing)
|
Difficulty with the way the brush is used
|
49
|
49
|
2.313
|
0.09
|
|
Difficulty in finding a suitable brush
|
25
|
25
|
|
Difficulty in maintaining brushing
|
52
|
52
|
|
Have you ever been treated in the dental clinic? (Yes, No)
|
No
|
54
|
54.0
|
3.414
|
0.077
|
|
Yes
|
46
|
46.0
|
|
The type of clinic that was treated
|
College of dentistry
|
2
|
2
|
2.009
|
0.033*
|
|
Government clinic
|
32
|
32
|
|
Private
|
19
|
19
|
|
Did you encounter difficulty in entering or moving between dental clinic facilities
in the hospital? (Yes, No)
|
No
|
33
|
33.0
|
0.998
|
0.021*
|
|
Yes
|
19
|
19.0
|
|
Did you face any problem while scheduling appointments? (Yes, No)
|
No
|
26
|
26.0
|
2.998
|
2.078
|
|
Yes
|
27
|
27.0
|
|
Did you have to wait a long time while you were in the dental clinic? (Yes, No)
|
No
|
28
|
28.0
|
1.881
|
0.099
|
|
Yes
|
22
|
22.0
|
|
Have you ever been refused treatment in the dental clinic? (Yes, No)
|
No
|
68
|
68.0
|
2.716
|
0.021*
|
|
Yes
|
22
|
22.0
|
|
Did you face any difficulty in communicating and dealing with workers in the health
center or hospital?
|
No
|
64
|
64.0
|
2.019
|
0.051*
|
|
Yes
|
27
|
27.0
|
|
If yes, the reason for rejection: (Lack of experience of the treating doctor, lack
of facilities or tools, not having the treating doctor on time for your appointment,
difficulty in communicating)
|
Difficulty in communicating
|
9
|
9
|
2.871
|
0.043*
|
|
Lack of experience of the treating doctor
|
15
|
15
|
|
Lack of facilities or tools
|
19
|
19
|
|
Not having the treating doctor on time for your appointment
|
17
|
17
|
|
During treatment in the dental clinic, was the dentist able to deal with the problem
you were experiencing (yes, no)
|
No
|
1
|
1.0
|
1.781
|
0.002*
|
|
Yes
|
38
|
38.0
|
|
Did you receive the required treatment correctly while you were in the dental clinic?
(Yes, No, up to a point)
|
No
|
12
|
12.0
|
2.441
|
0.032*
|
|
To some extent
|
9
|
9.0
|
|
Yes
|
29
|
29.0
|
|
How was your experience and satisfaction with the service provided to you? (excellent,
good, acceptable, bad)
|
Excellent
|
14
|
14
|
1.913
|
0.56
|
|
Good
|
10
|
10
|
|
Acceptable
|
17
|
17
|
|
Bad
|
7
|
7
|
|
Would you prefer to receive dental treatment at any of the following locations? (Yes,
No) (Primary care center clinic, dental clinic in a public hospital, dental clinic
in a dental center, dental clinic in a private center, dental clinic in a college
of dentistry)
|
Dental clinic in a dental center
|
35
|
35.0
|
2.417
|
0.075
|
|
Dental clinic in a private center
|
15
|
15.0
|
|
Dental clinic in a public hospital
|
27
|
27.0
|
|
Dental clinic in a college of dentistry
|
11
|
11.0
|
|
Primary care center clinic
|
5
|
5.0
|
|
If the answer is no, what are the reasons? (Fear, transportation, neglect, treatment
cost)
|
Fear
|
22
|
22.0
|
1.781
|
0.052*
|
|
Transportation
|
8
|
8.0
|
|
Treatment cost
|
29
|
29.0
|
Discussion
The present study not only describes the challenges and obstacles faced by caregivers
while getting disabled individuals treated for dental ailments but also the challenges
faced by dental professionals while managing such individuals. While the caregiver
group primarily consisted of parents, a small subset (4%) included patients with special
needs who were deemed capable of self-reporting. These patients, selected based on
their ability to comprehend and respond to the questionnaire, contributed valuable
firsthand insights. Their inclusion, although limited, provided a unique perspective
directly from the special care population. Although a significant proportion of our
dental professional participants were interns or early-career practitioners, their
inclusion provides valuable insight into the preparedness and challenges faced by
those entering the profession. These professionals often represent the front-line
care providers in government clinics and dental schools in regions like Jazan. Therefore,
their perspectives are instrumental in identifying gaps in training and resources
available for managing patients with special health care needs. To our knowledge,
no previous studies in the region have concurrently assessed both caregiver and dental
professional perspectives on this issue. Our study is the first of its kind that provides
detailed insight into the obstacles faced by caretakers and dental professionals in
the Jazan region of Saudi Arabia.
The study identified shared challenges and differing perspectives between parents
of patients with special needs and dental professionals. Notably, professionals reported
a lack of training and confidence, while parents highlighted accessibility and communication
as major concerns. A collaborative approach involving parent education, provider training,
and interdisciplinary coordination may help bridge this gap.
The findings of this study highlight several key areas where policy-level interventions
are needed. First, there is an urgent need to integrate comprehensive training in
special care dentistry into undergraduate and continuing education programs. Regulatory
bodies and academic institutions should mandate modules focused on communication techniques,
behavioral management, and clinical protocols for patients with special needs.
Second, health care infrastructure must be upgraded to ensure accessibility, including
the installation of signage in braille, wheelchair ramps, designated parking, and
sensory-friendly waiting areas. Government funding or incentives could support clinics
in meeting these requirements, especially in underserved areas like Jazan.
Third, interprofessional collaboration should be encouraged, particularly between
dental professionals and medical practitioners, to create a coordinated care network
for disabled individuals. This may involve establishing referral systems, case-sharing
protocols, and multidisciplinary case reviews.
Lastly, policies should address the financial burden faced by families. Subsidized
dental care programs, transportation assistance, and insurance coverage tailored for
special care dentistry would significantly reduce access barriers for this vulnerable
population. Public awareness campaigns aimed at educating caregivers about available
services can further support utilization and continuity of care.
Various studies mention bad oral hygiene status as the primary concern for tooth decay
among children with special health care needs—this is mainly because of disturbed
muscle coordination, associated medical ailments, and reduced dexterity, all of which
make brushing a difficult routine. In our study, parents realized that improper brushing
was the primary reason for poor oral hygiene, and dental caries was the most common
problem. Similar findings were reported in studies by Gambhir et al,[14] Al Agili et al,[15] Fotedar et al,[16] and Bhaskar et al.[17]
Financial burden, dental fear, transportation, accessibility and availability of dental
services, inadequate equipment, and insufficient training among dental professionals
are dominant reasons that impact the provision of adequate dental treatment. Besides
the financial barrier, we also observed that dental professionals lack the specialized
training for managing disabled patients. Alongside this, they also lack adequate knowledge
required for the specialized needs of disabled children and the facilities for such
patients, including signboards, parking, wheelchairs, etc. Very few specialist dentists
are available in the region, practicing and managing these disabled individuals. All
these factors contribute to the deprivation of proper oral health care to individuals
with special health care needs. The findings of our study are similar to results of
other studies by Purohit and Singh,[18] Kenney et al,[19] Onyejaka et al,[20] and Busato et al.[21]
Thus, the overall findings of this study suggest that the present scenario demands
the removal of social and physical barriers to provide disabled individuals with appropriate
dental treatment benefits. The variations in the population of the Jazan region make
it difficult for the recent findings to come to a conclusion regarding the various
obstacles involved in utilizing dental treatment for special health care individuals.
Different educational and specialized training programs are recommended for dentists
so that obstacles to delivering adequate dental care can be removed. Policies should
be made to cut down the treatment cost of disabled individuals and adequate knowledge
must be provided to caregivers to modify their perception about dental care.
One of the limitations of this study is that it did not differentiate between child
and adult patients with special health care needs. We acknowledge that these groups
have distinct clinical, behavioral, and caregiver-related challenges. Pediatric patients
often present different treatment dynamics compared with adult patients, including
behavioral management issues and differing oral health priorities. Similarly, the
role and concerns of caregivers vary depending on the age and dependency level of
the patient. Future research should consider stratifying participants based on patient
age to provide more tailored insights and recommendations for both pediatric and adult
special care dentistry. Another limitation of this study is the reliance on self-reported
questionnaire data, which can be subject to several forms of bias. Participants may
have provided responses they perceived as socially acceptable or professionally appropriate,
particularly regarding their level of preparedness or satisfaction. Caregivers might
also have been influenced by recall bias when reporting past experiences. These biases
may have led to underreporting or overreporting of certain challenges. Future research
may benefit from incorporating observational data, interviews, or triangulated methods
to validate and deepen the findings. Furthermore, this study relied entirely on self-reported
data without clinical validation. The inclusion of objective oral health assessments,
such as dental examinations or oral hygiene indices, would have enhanced the robustness
of our findings. Future studies should consider integrating such clinical measures
to correlate caregiver and professional perceptions with actual oral health outcomes.
Other limitations include a small sample size, responses by caretakers based on self-administered
questionnaires, and biased responses due to desired responses sought. We need further
studies to understand the extent of obstacles faced from the perspective of dental
care practitioners and caregivers found in this study.
Conclusion
The present study reveals that although parents and caregivers of disabled individuals
are getting dental care, they make up an inadequate proportion in the Jazan region
of Saudi Arabia, as the most common barriers involved include the cost of treatment
and the fear of getting dental treatment done by the dental care providers. As dental
professionals lack specialized training for managing disabled patients, different
educational and specialized training programs are recommended for dentists to remove
all obstacles involved in delivering adequate dental care to disabled patients. We
need policies to cut down the treatment costs involved in treating disabled individuals,
and caretakers must be furnished with knowledge to modify their perception regarding
dental care.
