The Special Care Dental Service
Good Dental care is as important as having a health check and regular visits should be made to Dentists.
The Special Care Dental Service provides dental care for children and adults who have special needs, including those with; learning disabilities, severe mental health problems, behavioural / management problems, child protection issues or looked after children, medical special needs, severe physical disabilities, autistic spectrum disorders, and dementia.
For those who are housebound or frail, a domiciliary service can be provided.
Someone with a learning disability may not be able express discomfort. Carers need to be aware of changes in behaviour, eating habits and general wellbeing to spot this. Patients with Learning Difficulties can find it difficult to cope with comprehensive treatment, as a result a more radical approach to treatment may be required.
Please contact: Lavinia Ellis LD Lead Special Care Dental Nurse
Royal South Hants Hospital Level B,
Fanshawe Wing Brinton’s Terrace,
Southampton, SO14 0YG
Tel: 02380 716501 Fax: 02380 716553 Email: lavinia.ellis@solent.nhs.uk
Reviewed: 24/04/2017
What does the The Special Care Dental Service do?
• We aim to provide and improve oral healthcare of individuals with an impairment or disability
• We have an understanding of each individual’s need and ability
• Offer acclimatisation/familiarisation appointments
• Specialist equipment
• Sedation and General Anaesthetic service
What are the barriers for people with Learning Disabilities when visiting the Dentist?
• Communication: There may be difficulties explaining if the patient has a problem or understanding treatment that needs to be carried out and what the consequences are if they do not want it. Our dental team will take the time to explain, at the patient’s level of understanding, and demonstrate (Show, Tell, Do). If our team feel the patient does not have the capacity to consent we will make arrangements for a ‘Best Interest’ meeting.
• Understanding: Oral health messages are reinforced at each visit. We promote healthy eating and effective tooth brushing (small headed toothbrush and fluoride toothpaste 1450ppm) to maintain a good healthy mouth.
• Mobility: Appointments can sometimes be cancelled at short notice due to staff shortages which may cause problems if patients are reliant upon the support of carers to take them to appointments. However cancelled appointments should always be followed up. • ''Dexterity:'' If the patient has poor dexterity there are different tools that can be used for example grips for toothbrushes. If they are reliant on a third party we can show carers how to brush teeth effectively or how to supervise.
• Medication: - A lot of medication will have side effects causing a dry mouth. It is encouraged to drink lots of water or there are saliva stimulant products that the dentist can recommend. Saliva is a cleanser for the mouth and washes food debris. - The risk from a dry mouth: sore/painful > unable to eat > behavioural changes: aggression > malnutrition - If food debris remains in the mouth there is a high risk of decay developing.
Poor oral health can cause:
• Bad breath
• Gum disease
• Recession
• Cavities/decay
• Pain
• Loss of teeth
Treatment planning
• Based around individuals needs and co-operation
• Regular monitoring - 2 monthly checks if there is a high risk
• Effective tooth brushing: Demonstrations for patient/carers
• Simple fillings/dressing in surgery
• Referral for sedation/GA, if there is NO co-operation
• Extractions if treatment is likely to fail
• Prosthetics may not be appropriate due to lack of tolerance
How can this service be accessed?
A referral can be made to the Special Care Dental Service, by Dentists, Doctors, any other Health or Social Care Professional, voluntary organisations and community groups, education/special schools, families and carers.
To be seen within our service the patient must be registered with a Hampshire General Medical Practitioner (GP)
The referral form can be downloaded from the Solent NHS Trust Website or requested from:
Solent NHS Trust Dental single Point of Access,
Level A Royal South Hants Hospital,
Brinton’s Terrace,
Southampton SO14 0YG
Tel: 02380 698677
Completed referral forms can be sent to the above address or emailed to SNHS.CentralPointofReferral@nhs.net or faxed to: 02380 713279.