Making reasonable adjustments to dentistry services for people with learning disabilities.
Good oral health can promote better communication and nutrition, and improve self-esteem and confidence, whereas poor oral health, in addition to detrimental effects on the above, can lead to pain and discomfort that people with learning disabilities may struggle to communicate.4 In extreme cases, this can lead to unnecessary and expensive interventions or services:
A psychiatrist from (an assessment and treatment unit) gave an example of someone being admitted with behaviour that had become very challenging, but within hours they found he had six deep cavities in his teeth, causing him extreme pain. Following treatment for this, he was back to his old self. 30 Oral health is not just the dentist’s problem; people with learning disabilities, family carers, support workers and providers, social care and health staff including specialist learning disability staff and GPs all have a part to play. Oral health is everyone’s business. 4 The British Society of Disability and Oral Health [BSDH] has produced comprehensive clinical guidelines on oral health care for people with learning disabilities and how it can be improved.31 The guidelines are aimed at everyone involved in the support of people with learning disabilities, and cover: • Barriers to Oral Health; • Improving oral health through clinical guidelines and integrated care; • Practical oral health information for service users, parents and carers; 3 • Commissioning of oral health care services for people with learning disabilities; • Education and training; • Consent to treatment and clinical holding; • Role of voluntary organisations. For further information see: http://www.bsdh.org.uk/guidelines/BSDH_Clinical_Guidelines_PwaLD_2012.pdf People with learning disabilities should be enabled to access dental services in the same way as anyone else. Local Salaried Primary Care Dental Services/Community dental services are available across the country, although special care dentistry services are also available.