Disabilities and dentistry

Disabilities and dentistry

According to government data, there are now almost 14 million people living with disabilities in the UK.[i] With such a large proportion of the population affected, it’s essential that dental hygienists and therapists understand how these conditions can impact patients’ oral health, provision of care, access to dental services, and more.

Melanie Pomphrett, dental hygienist and Ambassador for the British Society of Dental Hygiene and Therapy (BSDHT) discusses how she manages patients with disabilities and explains how dental hygienists and dental therapists are instrumental in helping this segment of society.

Oral care for disabled individuals

“Unfortunately, some disabled patients can have higher incidences of oral decay and other dental problems than those with more able bodies and minds: they may lack the dexterity or ability to brush their teeth properly. However, this is only one reason why they may be at increased risk.

“Other significant reasons may be a lack of a balanced diet, or they may have carers who are unaware of the importance of oral health and therefore are not looking after these needs as well as they could. This is a huge concern because, although carers do need to cover oral health as part of their training, this does sometimes fall by the wayside. A number of disabled people are therefore left at risk of developing poor oral health simply through lack of understanding.

“We also need to consider how restricted access to dental services can be for some individuals. If special measures, or anaesthesia, are required for treatment it can severely limit the available practice options.

“In light of this, I think dental hygienists and dental therapists are best placed to help these individuals receive excellent oral care – that is why it’s essential that we know how to overcome any challenges that can arise during treatment. If we see patients regularly, we can help prevent any issues from becoming a bigger problem, and this, in many cases, will help people avoid scarier, more drastic treatment further down the line. Importantly, they can also enjoy a better quality of life.”

Overcoming challenges

“There are so many challenges that come with treating people with disabilities, and these can be tricky to overcome. In my experience, one of the biggest tasks is helping those with considerable learning difficulties or mental disabilities receive treatment comfortably. Think of debridement and disruption of biofilm – this process often uses lots of water, and for some patients this can cause them to panic or feel unsafe. Even the act of putting a mirror in someone’s mouth can feel invasive and shocking, and can be a very negative experience for these patients, especially if they do not fully understand what’s going on.

“Building a rapport and a good relationship is absolutely vital. Ensure that you speak to the patient directly, as well as their carer. Talk them through every stage of the treatment and say exactly what you are going to do before you do it – this way there will be no nasty surprises and you can encourage compliance. Also, don’t be afraid to take time and go slowly. It’s better to be slow and steady and perform care in a calming way than to cause upset by trying to do everything fast.

“I have also heard of some patients having desensitising techniques (such as having a dental mirror put in their mouth and removed again a few times so that they can get used to the sensation) performed before they visit the practice. This is definitely something that carers should bear in mind as it really helps prevent any unpleasant surprises.

“Treating patients with physical disabilities is also tricky. Some people in wheelchairs may not be able to transfer to the dental chair. It seems obvious, but not always the case, to ensure that these individuals are always booked into a downstairs, easily accessible surgery. It’s also important to ensure that essential tools such as handpieces will reach across to any locations where you plan to position patients in the surgery – it’s all about making your practice an accommodating environment for all.”

Support from the BSDHT

“I joined the BSDHT when I was still a student, and I have always been so grateful for the support they have given me through the years. Now that I’m an Ambassador for the Society, I want to use my position to raise awareness of how important it is to be part of a professional organisation, especially one like the BSDHT that is always pushing for better representation and visibility for dental hygienists and dental therapists across the country.

“I also want to help fellow dental hygienists and dental therapists to better understand the needs of disabled patients and encourage them to give these people the best possible care. These individuals really do need a special approach, and it’s so worthwhile making small changes to give them the help they need.”

For more information about the BSDHT, please visit www.bsdht.org.uk

call 01788 575050 or email enquiries@bsdht.org.uk


[i] Department of Work and Pensions. Family Resources Survey 2016/2017. Link: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/692771/family-resources-survey-2016-17.pdf [Last accessed January 2020].


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