Objectives: This study aimed to identify the structural causes of chronic dental treatment backlogs at regional dental health centers for persons with disabilities, which stem from the overlap of mild and severe patients due to the absence of a proper dental delivery system. Consequently, it proposes a three-tier healthcare-welfare linked delivery system through the introduction of 'Local Dental Health Centers for Persons with Disabilities' to establish a robust oral health welfare safety net for vulnerable populations. Methods: Quantitative analyses of administrative data on wait times and domestic/international oral health and welfare policies for persons with disabilities were conducted. Furthermore, a comparative policy review of community-based dental services in developed nations and Focus Group Interviews (FGI) with multidisciplinary experts were implemented to design an actionable policy model. Results: The current system suffers from a severe bottleneck, evidenced by an average waiting time of 137 days for dental treatment under general anesthesia. To alleviate this crisis, this study designed a structured three-tier delivery system consisting of primary (dental home and public health centers), secondary (local centers), and tertiary (regional and central centers) institutions. Under this framework, the newly established secondary local centers are required to deploy a dedicated clinical team comprising at least one dentist and two dental hygienists, regardless of whether they operate in the public or private sector. Furthermore, an 'open designation system' is introduced to select institutions that satisfy rigorous criteria-—including the completion of mandatory specialized training and the provision of physical barrier-free accessibility facilities—thereby enabling them to exclusively manage mild to moderate cases. Conclusions: This study identifies structural causes of regional center backlogs and validates a three-tier oral health delivery system, proposing policies such as legislating secondary local centers and reforming financial incentives. The proposed healthcare-welfare linked model aims to establish a dense, community-centered safety net for persons with disabilities, though future research is needed to enhance practical efficacy through operational protocols and user-centered assessments.
