Preparedness of dentists to treat patients with intellectual and learning disabilities: a survey in Northern Thailand

Individuals with intellectual and learning disabilities (ILD) face significant barriers to dental care and experience disproportionately poor oral health outcomes. Evidence on dentists' preparedness, confidence, and stress in providing care for this population across public hospital settings in Thailand remains limited. A cross-sectional survey was conducted among 306 dentists in public-sector hospitals across 17 provinces of Northern Thailand (November 2024 to May 2025). A validated online questionnaire assessed individual-, institutional-, and system-level preparedness factors. Chi-square tests compared hospital settings, and multivariable binary logistic regression identified independent predictors of high confidence and high stress. Most respondents (80.72%) had experience treating patients with ILD, though 65.69% treated fewer than ten patients per year. The main challenges were communication difficulties (86.93%) and behavioural management difficulties (83.66%). High or very high stress was reported by 53.26%, and 15.69% reported stress reduced care quality. Access to specialist referral and facility readiness were significantly lower in community hospitals ( p < 0.001 and p = 0.003). Overall, 92.48% perceived undergraduate training as insufficient. In the multivariable analysis, adequate personnel and equipment was the only independent predictor of high confidence (OR = 2.739, 95% CI: 1.390–5.396, p = 0.004). High stress was independently associated with more than ten years of clinical experience (OR = 2.325, 95% CI: 1.272–4.251, p = 0.006), postgraduate education (OR = 1.926, 95% CI: 1.030–3.602, p = 0.040), and being a general dentist rather than a specialist (OR = 0.285, 95% CI: 0.146–0.555, p < 0.001). Dentists' preparedness is shaped by individual, institutional, and system-level factors. Adequate personnel and equipment was the key predictor of confidence, while stress was linked to clinical experience, postgraduate education, and professional role. Strengthening education, workplace resources, and referral support may improve preparedness and access to dental care for patients with ILD.