Background: This retrospective study aimed to investigate the oral and dental health conditions of individuals with special care needs. It also aimed to explore the association between educational status, type of disability, and the need for general anaesthesia, and to assess the feasibility of performing dental treatments in clinical settings without general anaesthesia. Methods: A retrospective cross-sectional design was used, including 211 individuals aged 2-34 years with disabilities such as Autism Spectrum Disorder (ASD), intellectual disability and Down syndrome. Demographic variables, educational background, type of disability, dental status assessed through the DMFT/dmft index (decayed, missing, and filled teeth; for permanent/primary dentition, respectively), treatments provided, presence of calculus, and indications for general anaesthesia were analysed using descriptive and non-parametric statistical methods. Results: The mean DMFT/dmft score was 4.3 ± 3.9 (median = 4). Dental calculus was found in 24% of participants. General anaesthesia was required for 23% of individuals, while 77% could be managed under routine clinical conditions without general anaesthesia. DMFT/dmft scores did not vary significantly by age, diagnosis or educational status (p > 0.05). The indication for general anaesthesia differed significantly by age group and diagnosis (p < 0.05), being more common among younger individuals and those with ASD. Conclusion: Not all individuals with special healthcare needs require general anaesthesia for dental treatment. With appropriate behavioural management, many can be treated under local anaesthesia. Enhancing preventive strategies, strengthening special education programmes, and improving access to regular dental care are essential to improving oral health outcomes in this vulnerable group.