Key Points
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The profession has a responsibility to ensure that people from all societal groups have access to oral health care services with good and equitable outcomes.
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The majority of people with a disability can, and should, be treated in mainstream general dental services.
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This paper explores models of good practice, the skills mix and facilities required to provide Special Care Dentistry and makes recommendations for future training and service delivery.
Abstract
As a profession we have a responsibility to ensure that the oral health needs of individuals and groups who have a physical, sensory, intellectual, medical, emotional or social impairment or disability are met. In the UK, over 200,000 adults have profound learning disabilities and/or complex medical conditions. Adults with a disability often have poorer oral health, poorer health outcomes and poorer access to services than the rest of the population. This paper examines the need for Special Care Dentistry based on a review of published literature, surveys and health policy, and suggests how services might be delivered in the future.
Existing models of good practice reveal that established clinicians working in this field have a patient base of between 850 and 1,500 patients per year and work across primary care and hospital settings, liaising with colleagues in health, social services and the voluntary sector to ensure integrated health care planning. On this basis, a conservative estimate of 133 specialists is suggested for the future, working in networks with Dentists with Special Interests (DwSIs) and primary dental care practitioners. A skilled workforce that can address the wider needs of people requiring Special Care Dentistry should be formally recognised and developed within the UK to ensure that the needs of the most vulnerable sections of the community are addressed in future.
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Acknowledgements
Dr Janice Fiske MBE is the Chair of the Joint Advisory Committee for Special Care Dentistry and Dr Jenny Gallagher is a former representative on that Committee. Both these authors worked on the JACSCD document A case for need: proposal for a Specialty in Special Care Dentistry on which this paper is based.1
The authors wish to acknowledge the contribution of the other members of JACSCD to A case for need: proposal for a Specialty in Special Care Dentistry and thank them for their permission to use and reproduce information from that document. Finally the authors wish to thank Julie Gallagher for assistance in preparing this paper.
The views presented within this paper are the personal views of the authors, rather than the NHS organisations which they represent, or the Department of Health.
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Gallagher, J., Fiske, J. Special Care Dentistry: a professional challenge. Br Dent J 202, 619–629 (2007). https://doi.org/10.1038/bdj.2007.426
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DOI: https://doi.org/10.1038/bdj.2007.426
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