SPECIAL NEEDS DENTISTRY: AN EVIDENCE-BASED REVIEW ON THE MANAGEMENT OF MEDICALLY COMPROMISED PATIENTS

Abstract

Patients with special needs, especially those with systemic compromises, represent a growing challenge in clinical dental practice. This narrative review explores the main systemic diseases that require specific adaptations in dental care, including diabetes mellitus, hypertension, cardiovascular disorders, cancer, chronic kidney and liver diseases, hematological disorders and immunosuppression. These conditions directly influence diagnostic and therapeutic planning, increasing the risk of complications such as bleeding, infections, delayed healing and systemic decompensation. The review highlights the importance of individualized care, interprofessional collaboration and clinical decision-making based on laboratory parameters and disease stability. Barriers to access, such as the scarcity of specialized services and limited academic training, are also discussed. Ethical and legal aspects, such as bioethics, patient autonomy and professional responsibility, are addressed as fundamental pillars of care. Despite the existence of clinical guidelines, there are still gaps in professional training and service infrastructure. This article advocates the inclusion of content on disability in dental curricula, the expansion of specialized centers and public policies that ensure equitable access to oral health services. Dentistry must move towards a more inclusive, ethical and evidence-based practice.