Referral Patterns of Special Needs Patients to the Oral Health Unit of Auckland District Health Board

Objectives: To describe and assess the referral patterns of Special Needs Dentistry (SND) patients at the Oral Health Unit (OHU), Auckland District Health Board. Methods: Referrals to the OHU between January 1 to June 30, 2015 were screened and data regarding demographics, medical history, medications and waiting time to initial appointment was recorded and analysed. Data collected included appointments for dental review at the multidisciplinary team meeting (MDM) and Oral Mucositis Clinic (OM) as part of the head and neck cancer service at Auckland City Hospital.
Results: 784 patients were referred for SND at the OHU, including 251 patients reviewed as part of the MDM and OM. 533 patients were referred for SND at the outpatients dental clinic, of which 64.9% were over the age of 50 (range 17-98 years), and 51.4% (n=274) were male. The mean waiting time was 48.21 days (range 0-151). Asian ethnicity was under-represented relative to the Auckland population. General medical practitioners provided 41.5% of referrals, while 36.8% of patients were reviewed by SND specialists. 81.6% of the entire cohort were classified as medically compromised. 82.0% had a single special needs classification, while 15.6% had two, and 1.9% three classifications. On average, a patient had 4.23 medical conditions (range 1-15) and was taking 5.15 medications (range 0-16).
Conclusions: The SND service at the OHU is a referral pathway for both community and hospital based specialists, while also being an integral part of a multidisciplinary team. Referrals reflect the compromised nature of patients referred for SND.