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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Quality and Patient Safety".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 34664

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Prof. Dr. Iole Vozza

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Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
Interests: pediatric dentistry; oral cancer; oral pathology; dental materials; medical device
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue welcomes manuscripts that can contribute the knowledge necessary to better understand the pathology, etiology, diagnosis, prevention, and management of oral pathologies in special needs patients. The listed keywords suggest just a few of the many possibilities. Preventive strategies in special needs patients should be implemented to reduce oral problems, due to the negative consequences for individuals and communities in terms of pain and suffering, functional impairments, and reduced quality of life. Psychosocial factors, such as improved awareness, knowledge, and attitudes toward dental health care in both children and adult special needs patients, are included in general health status improvements. The published findings should lead to improving the prevention and management of medical disorders affecting the oral and maxillofacial areas of these kind of patients adopting multi-, inter-, and transdisciplinary perspectives.

Prof. Dr. Iole Vozza
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

oral health prevention
oral health management
special needs patients
oral education

Related Special Issue

2nd Edition of Healthcare and Special Needs Patients in Healthcare (5 articles)

Published Papers (13 papers)

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Research

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14 pages, 257 KiB

Open AccessArticle

Perceptions of Care Quality during an Acute Hospital Stay for Persons with Dementia and Family/Carers

by Lynette Chenoweth, Janet Cook and Anna Williams

Healthcare 2021, 9(9), 1176; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9091176 - 07 Sep 2021

Cited by 5 | Viewed by 2467

Abstract

Objectives: to report on acute hospital care experiences for persons with dementia and family/carers in a pilot study (PiP) of person-centred care compared with usual care. Methods: participants were recruited from one acute aged care ward and one mixed medical/surgical ward. One-on-one interviews occurred soon after discharge using a semi-structured interview guide framed by person-centred principles whereby the person is: V—valued; I—treated as an individual; P—perceived as having a unique identity; and S—supported socially and psychologically. Data were analysed deductively with reference to these a priori principles. Results: 11 consented persons with dementia and 36 family/carers participated. A total of eight core VIPS concepts were derived from the data. While many occasions of person-centred care occurred, there was variability in staff expertise, interest and aptitude for dementia care work. Neglect of person-centred principles more frequently occurred for the usual care group, where staff failed to place the person and their family/carer at the centre of service. Conclusions: person-centred services for persons with dementia requires that hospital executive equip staff with the relevant knowledge, skills and support to adhere to person-centred care guidelines. Hospitals must address workplace cultures and procedures that favour organisational systems over person-centred services. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

9 pages, 999 KiB

Open AccessArticle

Masticatory Force in Relation with Age in Subjects with Full Permanent Dentition: A Cross-Sectional Study

by Ottavia Poli, Licia Manzon, Tarcisio Niglio, Evaristo Ettorre and Iole Vozza

Healthcare 2021, 9(6), 700; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9060700 - 09 Jun 2021

Cited by 16 | Viewed by 2320

Abstract

Masticatory performance is directly correlated with masticatory muscle work to grind and cut the food. Chewing efficacy is decisive to eating a variety of foods needed maintain general health status at all ages. Older people have oral problems that get worse with age. Elders have more pathologies such as periodontal diseases, caries, tooth loss and inadequate dental prostheses than younger subjects. Objectives: to investigate the correlation between masticatory bite force (MBF) and body mass index (BMI) vs. aging and sex. Methods: This study was performed on 426 subjects (213 females plus 213 male) assigned into five different groups by age. Group “A” aged from 20 to 35 years; group “B” aged 45–59 years; group “C” aged 60–69 years; group “D” aged 70–79 years; and group “E” aged more than 79 years. Results: There were not statistically significant differences in right-side MBF versus left-side MBF. The differences between sex were statistically significant with a stronger bite in males than females (p < 0.05). At the same time, younger subjects had a stronger bite than elders (p < 0.05). In group “E”, more corpulent subjects (BMI > 25) had an MBF higher than less corpulent subjects (BMI < 25, p < 0.05). The analysis of mean MBF showed a statistically significant difference within all groups stratified by BMI with mean values inversely proportional with age (p < 0.001). Conclusion: The results in our study confirm data from many scientific papers. The importance of the present paper was to correlate data between and within a large sample with a wide range of ages. Our sample subjects had a 31%–33% decrease in MBF from group “A” to group “E” group, but they all had full permanent dentation and they preserved a valid MBF. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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13 pages, 1829 KiB

Open AccessArticle

Phototherapy and Tailored Brushing Method. Personalized Oral Care in Patients with Facial and Dental Trauma. A Report of a Case

by Gianna Maria Nardi, Fabrizio Guerra, Artnora Ndokaj, Denise Corridore, Marsha Alicia Straker, Pasquale Sportelli, Roberto Di Giorgio, Felice Roberto Grassi, Roberta Grassi and Livia Ottolenghi

Healthcare 2021, 9(5), 561; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050561 - 11 May 2021

Cited by 4 | Viewed by 2093

Abstract

(1) Background: Traumatic dental injuries are frequent in children and young adults. The facial structures involved in dental trauma may include soft tissues of the face and mouth, bone and dental structures. Dental trauma often results in augmented dental anxiety. Phototherapy can improve stress and pain control thereby improving compliance in young patients with the necessary dental treatments, after dental trauma has occurred. (2) Methods: Phototherapy was performed to enable soft tissue healing. The Tailored Brushing Method (TBM), a personalized approach for at-home oral hygiene procedures, was also utilized, with the aim of improving biofilm control in traumatized patients. (3) Results: The approach hereafter presented made it possible to obtain subjective control of anxiety and pain documented on a visual analog scale (VAS) due to the innovative use of photo-biomodulation. In addition, for the first time, the TBM was adapted to the needs of a patient with facial trauma and illustrated. (4) Conclusions: Phototherapy and TBM were found to be effective in the combined treatment of soft tissue wounds and in the oral care of the traumatized patient. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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9 pages, 2242 KiB

Open AccessCommunication

Ultrashort Implants, Alternative Prosthetic Rehabilitation in Mandibular Atrophies in Fragile Subjects: A Retrospective Study

by Giovanni Falisi, Carlo Di Paolo, Claudio Rastelli, Carlo Franceschini, Sofia Rastelli, Roberto Gatto and Gianluca Botticelli

Healthcare 2021, 9(2), 175; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9020175 - 06 Feb 2021

Cited by 2 | Viewed by 1673

Abstract

This study aimed to evaluate the effectiveness of using ultrashort implants in the rehabilitation of jaws of fragile patients. The aim of the study was to retrospectively evaluate the survival rate of full-arch prosthetic rehabilitation on ultrashort implants, length 4 mm, 4 mm in diameter in the premolar and canine area and 4.5 mm in diameter in the molar area, with the insertion torque of 60 Nw and immediate loading. Nineteen patients were evaluated for 3 years clinically and radiographically. The significant majority of the patients at the 3 year follow-up (T4) presented a stable and functional implant-supported prothesis, and the survival rate of the implants was 85%, with a loss of 16 implants on 114 implants. The combination of the innovative implant surfaces and the correct project of the prostheses, with the related implant connection, determined a different timing in the therapy, allowing to obtain an immediate loading, which is currently demanded by patients. This and recent reports on short and ultrashort implant usage in atrophic jaws offer a good solution in critical cases. In conclusion, within the limits of the study, the full-arch rehabilitation with immediate loading on ultrashort implants showed good results with few postoperative complications and related low biological cost. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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12 pages, 2242 KiB

Open AccessArticle

The Evaluation of Further Complications after the Extraction of the Third Molar Germ: A Pilot Study in Paediatric Dentistry

by Giacomo D’Angeli, Francesca Zara, Iole Vozza, Francesco Maria D’Angeli and Gian Luca Sfasciotti

Healthcare 2021, 9(2), 121; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9020121 - 25 Jan 2021

Cited by 5 | Viewed by 2944

Abstract

Some authors suggest germectomy to prevent the impaction of mandibular third molars, which can cause anterior crowding. The aim of the study, conducted with 2 years of follow-up, was to clarify when the extraction of the germ of the third molar is optimal, together with possible post-operative complications. A new surgical approach was performed through the application of a combined suture, which can provide better wound healing. The study was performed on 25 patients with a mean age of 15.44 ± 2.06. Based on orthodontic and surgical indications, 46 germectomies were performed. Follow-ups were conducted after 1 week, 2 weeks, 4 weeks, 1 year and 2 years. All procedures were carried out by the same operator and were standardized. Data analysis was conducted using R-Software. Statistical evaluation used the chi-squared test and the Monte Carlo test. The level of significance was set as 0.05. Results showed that out of 46 germectomies, the prevalence of complications was 4.2% for two patients (8%). Both complications were observed in male patients. In the first case, the patient (at Nolla stage 7) showed delayed onset infections after four weeks; in the second case, the patient (at Nolla stage 6) showed bleeding immediately after surgery and suture. With reference to delayed onset infections, no statistically significant association was found among gender (χ² = 0.719; p = 0.396), germ development stage (χ² = 2.595; p = 0.658) or Winter’s classifications (χ² = 0.046; p = 0.829); similarly, no significant associations were found among bleeding, gender (χ² = 0.719; p = 0.396), germ development stage (χ² = 2.595; p = 0.658) or Winter’s classification (χ² = 0.046; p = 0.829). From our results, it is also possible to state that post-operative complications following germectomy of the mandibular third molar germ in adolescence occur in a significantly reduced percentage of patients, so this oral surgery treatment becomes a reliable surgical technique in adolescence. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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12 pages, 3381 KiB

Open AccessArticle

New 3D Cone Beam CT Imaging Parameters to Assist the Dentist in Treating Patients with Osteogenesis Imperfecta

by Daniela Messineo, Valeria Luzzi, Francesca Pepe, Luca Celli, Arianna Turchetti, Anna Zambrano, Mauro Celli, Antonella Polimeni and Gaetano Ierardo

Healthcare 2020, 8(4), 546; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare8040546 - 10 Dec 2020

Cited by 4 | Viewed by 2161

Abstract

(1) Background: The aim of the work is to identify some imaging parameters in osteogenesis imperfecta to assist the dentist in the diagnosis, planning, and orthodontic treatment of Osteogenesis Imperfecta (OI) using 3D cone beam Computed Tomography (CBCT) and the Double Energy X-ray Absorptiometry (DEXA) technique. (2) Methods: 14 patients (9 males and 5 females; aged mean ± SD 15 ± 1.5) with a clinical-radiological diagnosis of OI were analyzed and divided into mild and moderate to severe forms. The patients’ samples were compared with a control group of 14 patients (8 males and 6 females; aged mean ± SD 15 ± 1.7), free from osteoporotic pathologies. (3) Results: The statistical analysis allowed us to collect four datasets: in the first dataset (C1 sick population vs. C1 healthy population), the t-test showed a p-value < 0.0001; in the second dataset (C2 sick population vs. C2 healthy population), the t-test showed a p-value < 0.0001; in the third dataset (parameter X of the sick population vs. parameter X of the healthy population), the t-test showed a p-value < 0.0001; in the fourth dataset the bone mineralometry (BMD) value detected by the DEXA technique compared to the C2 value of the OI affected population only) the Welch–Satterthwaite test showed a p-value < 0.0001. (4) Conclusions: The research has produced specific imaging parameters that assist the dentist in making diagnostic decisions in OI patients. This study shows that patients with OI have a characteristic chin-bearing symphysis, thinned, and narrowed towards the center, configuring it with a constant “hourglass” appearance, not reported so far in the literature by any author. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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12 pages, 983 KiB

Open AccessArticle

The Characteristics of Adjacent Anatomy of Mandibular Third Molar Germs: A CBCT Pilot Study in Patients with Osteogenesis Imperfecta

by Giacomo D’Angeli, Daniela Messineo, Mara Riminucci, Alessandro Corsi, Mauro Celli, Iole Vozza and Gian Luca Sfasciotti

Healthcare 2020, 8(4), 372; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare8040372 - 30 Sep 2020

Cited by 5 | Viewed by 1955

Abstract

(1) Objectives: The aim of our study was to investigate the anatomical features of lower third molar and its adjacent anatomical connections in type I Osteogenesis Imperfecta (OI) patients through cone beam computed tomography (cbct). (2) Methods: The study was conducted among 25 patients, 13 patients with type I OI and 12 control patients (individuals with no disorders and no treatment); average age was 15.44 ± 2.06, 23 third molar germs for each group. The germs have been compared to the parameters using the Mann-Whitney test. A chi-square test was also used to investigate the correlation between the status case/control and tooth development stage. (3) Results: Mann-Whitney test showed significant differences between cases and controls: diameter of the tooth germ in toto (U = 93.5; p < 0.001), tooth development stage, (U = 145; p < 0.01), roots length (U = 44.5; p < 0.01), cementoenamel junction diameter (U = 157.5; p < 0.05), size of the pulp chamber (U = 95.5; p < 0.05). Type I OI is not associated with the relationship between the germ of mandibular third molar and alveolar canal on axial plane (χ² = 4.095; p = 0.129), and parasagittal (χ² = 4.800; p = 0.091). The association between type I OI and relationship with the germ of mandibular third molar and alveolar canal on the coronal plane has been significant (χ² = 9.778; p < 0.05) as the perforation of the lingual cortical bone in the region of mandibular third molar tooth germ (χ² = 11.189; p < 0.01). (4) Conclusions: The results confirm the cbct accuracy in the evaluation of bone density in type I OI patients giving also the opportunity to study the tridimensional anatomy of germs and the adjacent anatomical structures in order to avoid any perioperative complications. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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Review

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20 pages, 839 KiB

Open AccessReview

Laser Photobiomodulation (PBM)—A Possible New Frontier for the Treatment of Oral Cancer: A Review of In Vitro and In Vivo Studies

by Alessandro Del Vecchio, Gianluca Tenore, Maria Clotilde Luzi, Gaspare Palaia, Ahmed Mohsen, Daniele Pergolini and Umberto Romeo

Healthcare 2021, 9(2), 134; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9020134 - 29 Jan 2021

Cited by 11 | Viewed by 3605

Abstract

The treatment of oral squamous cell carcinoma (OSCC) is particularly complex due to its aggressive behavior, location, the patient’s age, and its spread at diagnosis. In recent years, photobiomodulation (PBM) has been introduced in different medical fields; however, its application, in patients suffering from OSCC for palliative support or to induce analgesia, has been hotly debated due to the possibility that the cell growth stimuli induced by PBM could lead to a worsening of the lesions. The aim of this study is to review the literature to observe the available data investigating the effect of PBM on cancer cells in vitro and in vivo. A review was conducted on the PubMed and Scopus databases. A total of twelve studies met the inclusion criteria and were therefore included for quality assessment and data extraction. The analysis showed that the clinical use of PBM is still only partially understood and is, therefore, controversial. Some authors stated that it could be contraindicated for clinical use in patients suffering from SCC, while others noted that it could have beneficial effects. According to the data that emerged from this review, it is possible to hypothesize that there are possibilities for PBM to play a beneficial role in treating cancer patients, but further evidence about its clinical efficacy and the identification of protocols and correct dosages is still needed. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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Other

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8 pages, 5885 KiB

Open AccessCase Report

Aesthetic and Functional Rehabilitation of Patients with Genetic Microdontia: A Multidisciplinary Approach

by Cindy Batisse, Pierre-Yves Cousson, Emmanuel Nicolas and Marion Bessadet

Healthcare 2022, 10(3), 485; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10030485 - 05 Mar 2022

Cited by 1 | Viewed by 1774

Abstract

This case report presents the treatment of a 33-year-old patient with a genetic, generalized microdontia of permanent teeth. Microdontia is a developmental dental anomaly of the teeth characterized by a decrease in their size. In the literature, treatment has been multidisciplinary, often utilizing orthodontics and implantology. However, for adult patients with generalized microdontia who do not benefit from these treatments as much, a combination of adhesive dentistry, endodontics and removable prostheses remains a therapeutic alternative to consider. Given the specificities of the patient and the nature of the care, the objective of this treatment option was to manage the patient’s comfort while guaranteeing quality of care. A feature of this treatment was the use of general anesthesia for endodontic treatments and exodontia. Chairside CAD/CAM and adhesive dentistry reduced the chairside time and preserved healthy dental tissue. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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11 pages, 6373 KiB

Open AccessCase Report

Comprehensive CAD/CAM Prosthetic Rehabilitation Management in a Young Patient with Agenesis: A Case Report

by Noémie Drancourt, Emmanuel Nicolas, Jean-Luc Veyrune and Marion Bessadet

Healthcare 2022, 10(2), 382; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10020382 - 17 Feb 2022

Viewed by 1983

Abstract

With the advancement in ceramic restorations bonded to the tooth structure, the treatment has become a practicable and conservative option to restore teeth with shape alteration owing to the high demand for aesthetics, with minimum tooth preparation. This article describes the case of a 25-year-old man who was dissatisfied with his smile. After an assessment of the clinical situation, a decision was made to place a full-mouth prosthodontic rehabilitation (monolithic lithium disilicate glass-ceramic, IPS E-max CAD) with minimal tooth preparation, which figures as a conservative full-coverage approach. The restoration of an aesthetic smile resulted in the patient’s satisfaction. Bonding of all monolithic veenerlay and crowns onto minimally prepared teeth figures as conservative treatment in cases of hypodontia. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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7 pages, 1927 KiB

Open AccessCase Report

Biodentine^TM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis

by Xuan Vinh Tran, Lan Thi Quynh Ngo and Tchilalo Boukpessi

Healthcare 2021, 9(6), 720; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9060720 - 12 Jun 2021

Cited by 12 | Viewed by 3906

Abstract

Vital pulp therapy, including direct pulp capping and partial and full pulpotomy, is primarily indicated for immature or mature permanent teeth with reversible pulpitis. Mature permanent teeth with irreversible pulpitis are frequently treated with root canal therapy. This report presents two cases of full pulpotomy using Biodentine^TM in mature permanent teeth with irreversible pulpitis and acute apical periodontitis. The periapical radiograph illustrated a deep carious lesion extended to the pulp with apical radiolucency lesion or widened periodontal ligament space. Full pulpotomy with a tricalcium silicate-based cement was chosen as the definitive treatment. After decayed tissue excavation under a rubber dam, the exposed pulp tissue was amputated to the level of the canal orifice with a new sterile bur. Biodentine^TM was applied as the pulp capping agent after hemostasis was obtained and for temporary restoration. The clinical signs disappeared quickly after the treatment. After one month, the coronal part of the temporary restoration was removed, and a composite resin was placed over the capping agent as a final restoration. At two-year follow-ups, the teeth were asymptomatic. Radiographs showed healing of the periapical lesion and periodontal ligament. Biodentine^TM full pulpotomy of mature permanent teeth with irreversible pulpitis and apical periodontitis can be an alternative option to root canal therapy. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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14 pages, 555 KiB

Open AccessCase Report

Preventive Healthcare and Management for Acute Lymphoblastic Leukaemia in Adults: Case Report and Literature Review

by Wei-Ping Chen, Wen-Fang Chiang, Hung-Ming Chen, Jenq-Shyong Chan and Po-Jen Hsiao

Healthcare 2021, 9(5), 531; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050531 - 02 May 2021

Cited by 2 | Viewed by 2214

Abstract

Acute lymphoblastic leukaemia (ALL) is diagnosed by the presence of at least 20% lymphoblasts in the bone marrow. ALL may be aggressive and include the lymph nodes, liver, spleen, central nervous system (CNS), and other organs. Without early recognition and timely treatment, ALL will progress quickly and may have poor prognosis in clinical scenarios. ALL is a rare type of leukaemia in adults but is the most common type in children. Precipitating factors such as environmental radiation or chemical exposure, viral infection, and genetic factors can be associated with ALL. We report a rare case of ALL with symptomatic hypercalcaemia in an adult woman. The patient presented with general weakness, poor appetite, bilateral lower limbs oedema, consciousness disturbance, and lower back pain for 3 weeks. She had a history of cervical cancer and had undergone total hysterectomy, chemotherapy, and radiation therapy. Her serum calcium level was markedly increased, at 14.1 mg/dl at admission. Neck magnetic resonance imaging, abdominal sonography, abdominal computed tomography, and bone marrow examination were performed. Laboratory data, including intact parathyroid hormone (i-PTH), peripheral blood smear, and 25-(OH) D3, were checked. Bone marrow biopsy showed B cell lymphoblastic leukaemia. Chemotherapy was initiated to be administered but was discontinued due to severe sepsis. Finally, the patient died due to septic shock. This was a rare case of B cell ALL in an adult complicated by hypercalcaemic crisis, which could be a life-threatening emergency in clinical practice. Physicians should pay attention to the associated risk factors. Early recognition and appropriate treatment may improve clinical outcomes. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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12 pages, 1296 KiB

Open AccessSystematic Review

The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis

by Valendriyani Ningrum, Abu Bakar, Tzong-Ming Shieh and Yin-Hwa Shih

Healthcare 2021, 9(4), 410; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9040410 - 02 Apr 2021

Cited by 17 | Viewed by 3763

Abstract

This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004–2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children’s oral health are important to maintain special needs children’s oral health. Full article

(This article belongs to the Special Issue Healthcare and Special Needs Patients)

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