Characteristics of Patients Attending Gerodontology and Special Care Dentistry Outpatient Clinic in Thailand and the Referral Reasons by Dentists and Auxiliaries.

Abstract

Background: There has been no study addressing referral reasons to gerodontology and special care dentistry (GD/SCD) clinics in Thailand. It was unclear how Thai dentists perceived the scope of care.

Objectives: This study aimed to (1) describe the characteristics of patients attending the GD/SCD clinic of Thammasat University Hospital (TUH) and (2) explore the referral reasons from the perspectives of dentists and auxiliaries.

Methods: We reviewed the electronic medical record (EMR) of the calendar year of 2019 for patient profiles as well as written reasons for referral. Later, we conducted in-depth interviews with seven dentists and five auxiliaries to explore their reasons. Inductive thematic content analysis was employed with the consensus between the two researchers.

Results: EMR revealed that among 328 patients, most patients were in a young-old group (mean age 69.1±10.1), who had 5.1±3.8 comorbidities and took 8.2+5.5 medications. Reasons for referral include: complex dental problems, being dependent, and uncooperative. Dentists struggled with the treatment planning and the issue of efficiency. However, shorter waiting time for denture fabrication for healthy older adults was also identified. Interview informants expressed empathy/sympathy and referred patients to the GD/SCD clinic as they explained the clinic had specialized equipment and skills, ease of referral, and one-stop-service comprehensive care. In addition, we did not find that ageism or lack of financial incentive was an issue.

Conclusion: Referrals were mostly due to behavioural challenges and uncertainties in treatment planning. However, some referrals of patients with no special needs were still evident.