Special education teachers' involvement and perceived barriers to delivering oral health education for students with disabilities—A cross-sectional study

Background: Dental caries is prevalent among children, including those with disabilities. Although the World Health Organization recommends school-based oral health promotion (OHP) programmes involving teachers, limited research has explored teachers' roles and perspectives. Aim: To assess special education teachers' involvement and difficulties regarding oral health education (OHE), attitudes towards OHP and barriers to oral healthcare access for students with disabilities (SWDs). Design: This descriptive cross-sectional study, conducted in Al-Ahsa, Saudi Arabia, involved 264 special education teachers using a validated, self-administered questionnaire, and descriptive and analytical statistics were used for data analysis. Results: Only 39% of teachers incorporated OHE into their teaching, and just 20.8% received training for OHE delivery. Teachers showed strong support for integrating OHE into the curriculum (84.1%) and a no-sugar policy (78%). There was, however, less support for school-based toothbrushing (39%). OHE barriers included insufficient resources (56.1%), limited knowledge (29.2%) and misconceptions about primary teeth removal (47.4%). The three most common barriers to oral healthcare access were extended waiting lists (75.0%), long waiting times (73.1%) and fear of dental equipment (67.4%). Conclusion: This study highlights the need for collaboration between healthcare professionals, educators and parents to enhance OHE and reinforce OHP for SWDs within special education and beyond.