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Northern Lincolnshire & Goole NHS Foundation Trust - Community Dental Service

The Community Dental Service is commissioned to provide dental care to groups for whom access to services is especially difficult. Special emphasis is placed on children with high needs, individuals with disabilities and compromising medical problems and the frail elderly. The service also provides domiciliary care and where necessary facilities for conscious sedation and general anaesthesia. In addition to the clinical care the Community Dental Service also works with Public Health England in promoting good oral health for target groups. Included in this are those living in residential and nursing homes or living at home but dependant on others for daily care.

1 April 2015
Yorkshire and Humber
Hospitals and Hospital Trusts, Health
Local Alliances:
North East Lincolnshire Dementia Action Alliance, North Lincolnshire Dementia Action Alliance, Yorkshire & Humber Dementia Action Alliance

1. Action Plan

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

A visit to a dental surgery can be distressing for individuals with dementia and their carers and having dementia will often impact on someone’s oral health, especially if that person is dependant upon others for personal care.   

Not only are more people living into old age in the UK but far more of them are keeping their natural teeth and this is presenting dental services challenges as they seek to meet the needs of their service users.

The Community Dental Service employs dentists who are salaried rather than self employed and is commissioned in such a way as to allow staff to adapt their care around the needs of users.  This commonly involves booking appointments with sufficient time  to allow for clients who may be anxious about the clinical environment or have difficulties with communication. 

Domiciliary care is provided where there are significant issues around mobility and/or where it is considered more appropriate to take the dental care to an individual who feels more comfortable in familiar surroundings.

The Community Dental Service has established links with Social Services, the Voluntary Sector and other health care providers in order to facilitate referrals for their users

2. What are the challenges to delivering these outcomes from the perspective of your organisation?

1. Awareness of the dental staff

2. The changing demographics and oral health of the population: people in general are living longer and retaining their own teeth.  These natural teeth are often heavily restored and can deteriorate rapidly once a person becomes dependant on others for their personal care

3. Our service is the only provider of domiciliary care

4. Care staff often find providing oral health care difficult

5. Other providers of health and social care often do not refer a person in for dental care until that person is experiencing pain, by which time much of the damage to the teeth has been done

6. More work is needed to ensure that in a residential or nursing setting care plans include looking after a person’s oral health

2. Actions

  • To improve access to dental services for people with dementia

    1.  Ensure that local providers of social and health care are aware of the Community Dental Service

    2. Share with other providers the referral criteria and how to refer into the Community Dental Service

    3. Provide information, and where necessary training to other providers about the impact that dementia may have on a person’s oral health

    4. Work with commissioners and Dental Public health to ensure that adequate funds are available and that the right model for commissioning is being used

    5. Ensure that the full ranges of services are maintained, this includes appropriately equipped spacious dental surgeries, domiciliary care, conscious sedation and general anaesthesia

  • Promote good oral health for people with dementia

    1. Ensure that information given to service users is appropriate and evidence based.  Written material must be available which is easy to understand

    2. Apply topical fluoride varnish and prescribe toothpaste with high levels of fluoride as necessary

    3. Provide training to providers of care about maintaining good oral health for their clients

    4. Work with nursing and residential homes to ensure that oral health is recognised in care plans and that the daily care provided is appropriate for each person

    5. Participate in any epidemiological studies as directed by Public Health England which are relavant to understanding oral health and dementia

  • Improve dementia awareness amongst dental professionals

    1. Make provision for dementia awareness sessions for staff within the Community Dental Service

    2. Use staff meeting to share good practice

    3. Disseminate information regarding training to local dental practices

    4. Promote the attendance to relevant training and courses provided by the deanery