Dental Tribune United Kingdom Edition

S pecial care dentistry is the branch of dentistry that aims to improve and se- cure the oral health of individu- als and groups in society who have a physical, sensory, intel- lectual, mental, medical, emo- tional or social impairment or disability, or, more often a com- bination of these factors. It is defined by a diverse cli- ent group with a range of dis- abilities and complex additional needs and includes people living at home, in long stay residential care and secure units as well as homeless people. Clearly not every individual encompassed by this definition requires spe- cialist care and the majority of people can and should be treated by the primary dental care network. The ethos of special care dentistry is its broad based phi- losophy of provision of care. It achieves the greatest benefit for patients by taking a holistic view of oral health, liaising and working with all other members of an individual’s care team (be they dental, medical or social) to achieve the most appropriate care plan and treatment for that patient through an integrated care pathway. Special care dentistry works to the needs of people with dis- abilities, recognising the many barriers that some groups of people encounter. Special care patients have many barriers of which are: access, communica- tion, consent issues, education, safety of the patient and dental staff treating, seamless care, physical, financial and patients, carers or families attitudes to- wards oral health. Special care dentistry also includes screening and domi- ciliary visits, preventive and treatment programmes tailored to meet the specific needs of groups or individuals. People who need special care dentistry largely fall within the definition of disability as de- fined in the Equality Act of 2010, formerly known as the Disabil- ity Discrimination Act. The DDA gives disabled people the right to equal access to services in- cluding dental treatment. Under the DDA reasonable measures should be taken to make dental premises more ac- cessible to disabled people. The other act relevant to special care dentistry is the Mental Capacity Act 2005 which has five statutory principles to protect and support people with learning disabilities. These principles are: 1A person must be assumed to have capacity unless it is es- tablished that they lack capacity 2A person is not to be treated as unable to make a decision unless all practical steps to help them to do so have been taken without success 3A person is not to be treated as unable to make a decision merely because they make an unwise decision 4An act done or decision made under this act for or on behalf of a person who lacks capacity must be done in their best interest 5Before act is done or deci- sion is made on behalf of a per- son who lacks capacity should be done in the least restrictive manner of the person’s basic rights and freedoms As a dental nurse it is not compulsory to have any post qualification, you can work with Special Care patients but the NEBDN do a post qualification certificate in Special Care Den- tal Nursing. To be a special care dental nurse you need to show empathy, understanding and pa- tience at all times, giving every patient the dignity, respect and confidentiality they deserve. For anyone wishing to com- plete the post qualification cer- tificate in Special Care Dental Nursing the course involves sev- eral study days; you must com- plete 20 log sheets and three expanded case studies meeting the required elements, ie differ- ent disabilities/care needs. The exam is a three section written paper, first is a multiple choice, then a long answer care plan and finally three short answer questions. DT Special care dentistry Margaret Martin provides an insight into the ethos of special care dentistry About the author Margaret began her career in dental nursing in 1988 working in a multi surgery NHS general dental practice in Stockport as a nurse, receptionist and practice manager. She gained her NEBDN certificate in 2004. In 2005 she completed and passed post qualification in Oral Health Educa- tion Foundation certificate. In 2006, after 18 years in practice due to the sale and re-organisation of the prac- tice, Margaret accepted a post as a dental nurse at Manchester Commu- nity Dental Service and has gained the NEBDN certificate in conscious seda- tion in 2007. Initially working in a sin- gle surgery with a Dental Officer, now in a multi surgery teaching clinic, she assists students from Manchester Uni- versity at outreach for Paediatrics and the Senior Dental Officer a Special- ist in Special Care Dentistry treating children and adults with varying de- grees of special needs on a daily basis. In 2011 she gained the NEBDN certifi- cate in Special Care Dental Nursing. She hopes to do the extended clinical duties for dental nurses in Fluoride application and impression taking. January 23-28, 2012United Kingdom Edition Special care dentistry provides the greatest provision of care for patients with specific medical needs