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Background: Managing paediatric patients with special health care needs (SHCN) presents significant behavioural and operational challenges in clinical dentistry. Although medical and functional classification systems are available, they may not directly reflect the adaptations and care settings required for dental treatment. Aim: To introduce a four-category stratified clinical framework for classifying children with SHCN according to anticipated dental management requirements. Technical Design: The proposed framework comprises four categories: Category I (Routine Dental Care), for children who can receive care in routine dental settings with minor support; Category II (Modified Dental Care), for children requiring additional behavioural, environmental, communication or accessibility adaptations; Category III (Advanced Dental Care), for children requiring specialised techniques, multidisciplinary coordination or referral to hospital-based dental services; and Category IV (Comprehensive/Complex Dental Care), for children with profound disabilities or life-threatening systemic conditions requiring complex hospital-based dental management. Classification is based on anticipated treatment complexity and necessary modifications to dental care rather than diagnosis alone. Conclusion and Clinical Significance: The proposed four-category framework may support individualised treatment planning, clinical adaptations, referral decisions and communication among dental teams, caregivers and other healthcare professionals. As a conceptual proposal, the framework requires formal validation before its reliability and clinical utility can be established.
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Singh et al. (2026) studied this question.
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