Department of Community Department of Community Special Care DentistrySpecial Care Dentistry

Rob HaleRob Hale

Consultant in Special Care Consultant in Special Care DentistryDentistry

Deputy Head of DepartmentDeputy Head of Department

Salaried primary dental care Salaried primary dental care servicesservices

HistoryHistory

School dental serviceSchool dental service Community dental servicesCommunity dental services Personal dental servicesPersonal dental services Salaried primary dental care servicesSalaried primary dental care services

Salaried Primary Dental Care Salaried Primary Dental Care ServicesServices

All dentists must be on PCT All dentists must be on PCT performers listperformers list

Patient charges to be leviedPatient charges to be levied

Submission of FP17sSubmission of FP17s

Department of Community Department of Community Special Care DentistrySpecial Care Dentistry

Hosted by King’s College Hospital NHS Hosted by King’s College Hospital NHS TrustTrust

Based at King’s College London Dental Based at King’s College London Dental InstituteInstitute

Consultant-ledConsultant-led Primary and secondary care elementsPrimary and secondary care elements Lambeth, Southwark & LewishamLambeth, Southwark & Lewisham

Department of Community Department of Community Special Care DentistrySpecial Care Dentistry

Clinical roleClinical role HowHow WhereWhere Who forWho for

Public health rolePublic health role ScreeningScreening EpidemiologyEpidemiology Oral health promotionOral health promotion

Educational roleEducational role UndergraduateUndergraduate postgraduatepostgraduate

Clinical roleClinical role

Consultant ledConsultant led 3 consultants3 consultants 2 specialists2 specialists

Community basedCommunity based Hospital basedHospital based Mobile dental serviceMobile dental service Domiciliary careDomiciliary care General anaesthesiaGeneral anaesthesia Sedation servicesSedation services

ClinicsClinics

LambethLambeth Clapham ManorClapham Manor ElmcourtElmcourt Mawbey BroughMawbey Brough Myatts FieldMyatts Field Railton RoadRailton Road WhittingtonWhittington

Brixton prisonBrixton prison

Southwark Southwark ListerLister John DixonJohn Dixon AylesburyAylesbury

LewishamLewisham DownhamDownham JennerJenner WaldronWaldron

Who for?Who for?

ChildrenChildren High caries ratesHigh caries rates Behavioural/management issuesBehavioural/management issues Special care needsSpecial care needs

AdultsAdults Special care dentistrySpecial care dentistry

Special Care DentistrySpecial Care Dentistry

Special care dentistry is concerned with Special care dentistry is concerned with providing and enabling the delivery of oral providing and enabling the delivery of oral care for people with an impairment or care for people with an impairment or disability.. in the broadest terms.disability.. in the broadest terms.

Special Care DentistrySpecial Care Dentistry

.. .. is concerned with the improvement of oral is concerned with the improvement of oral health of individuals and groups in society health of individuals and groups in society who have a physical, sensory, intellectual, who have a physical, sensory, intellectual, mental, medical, emotional or social mental, medical, emotional or social impairments or disability, or more often a impairments or disability, or more often a combination of these factorscombination of these factors

Special Care DentistrySpecial Care Dentistry

……it requires a holistic approach that is it requires a holistic approach that is specialist led in order to meet the specialist led in order to meet the complex needs of people with complex needs of people with impairmentsimpairments

Training in Special Care DentistryTraining in Special Care Dentistry

Joint Advisory Committee in Special Care Dentistry Sept 2003Joint Advisory Committee in Special Care Dentistry Sept 2003

Multi-disciplinary workingMulti-disciplinary working

Patient GroupsPatient Groups

Learning disabilitiesLearning disabilities Challenging behaviourChallenging behaviour Medically compromisedMedically compromised Neurological impairmentNeurological impairment Physical disabilitiesPhysical disabilities Older peopleOlder people Mental health issuesMental health issues SyndromesSyndromes

Public Health RolePublic Health Role

ScreeningScreening 5year olds in state schools5year olds in state schools Residential/nursing homesResidential/nursing homes

EpidemiologyEpidemiology BASCD surveys – 5/12 year oldsBASCD surveys – 5/12 year olds Adult Dental Health SurveyAdult Dental Health Survey

Oral Health PromotionOral Health Promotion

Oral Health PromotionOral Health Promotion

Generic teamGeneric team

wide range of settings and to all age groupswide range of settings and to all age groupseg for example training carers of elderly, input to life skills courses for adults eg for example training carers of elderly, input to life skills courses for adults with special needs. with special needs.

15 ‘Target’ Schools prioritised as schools with the highest levels of untreated 15 ‘Target’ Schools prioritised as schools with the highest levels of untreated disease along with other indicators of deprivation disease along with other indicators of deprivation

Children’s Centre teamsChildren’s Centre teams

promote oral health for families with children aged under five. promote oral health for families with children aged under five. e.g.service delivery in baby clinics and the use of large scale e.g.service delivery in baby clinics and the use of large scale campaigns across Children Centre localities and adjoining school campaigns across Children Centre localities and adjoining school nursery population.nursery population.

services designed to increase reach to vulnerable / hard to reach services designed to increase reach to vulnerable / hard to reach groups. groups.

Providing training for staff and partnership working with other health Providing training for staff and partnership working with other health and community teams.and community teams.

Educational RoleEducational Role

UndergraduateUndergraduate Year 4 – domiciliary careYear 4 – domiciliary care Year 5 special care dentistryYear 5 special care dentistry

PostgraduatePostgraduate Vocational traineeVocational trainee SHOsSHOs MFDS traineesMFDS trainees Specialty registrarSpecialty registrar

Dental care professionalsDental care professionals Therapy studentsTherapy students

Departmental staffDepartmental staff

Dr. Liana Zoitopoulos Dr. Liana Zoitopoulos (Head)(Head)

Dr. Rob Hale (Dep Head)Dr. Rob Hale (Dep Head) Dr. Guy PalmerDr. Guy Palmer 2 Specialists2 Specialists 9 senior dental officers9 senior dental officers 8 dental officers8 dental officers 1 specially registrar in SCD1 specially registrar in SCD 1 vocational trainee1 vocational trainee 2 SHOs2 SHOs 1 hygienist1 hygienist

Dental service managerDental service manager 4 administrative staff4 administrative staff 2 dental nurse managers2 dental nurse managers 6 senior dental nurses6 senior dental nurses 12 dental nurses12 dental nurses 5 receptionists5 receptionists 2 joint oral health 2 joint oral health

promotion managerspromotion managers 3 generic OHP3 generic OHP 6 children centre OHP6 children centre OHP

ReferralsReferrals

Referrals received from Referrals received from GDPsGDPs GMPsGMPs Other health and social care professionalsOther health and social care professionals Self – mainly domiciliary careSelf – mainly domiciliary care

From Jan 2009From Jan 2009 945 new referrals received945 new referrals received 936 accepted936 accepted

Referrals AcceptedReferrals Accepted

One off items of careOne off items of care

Long term oral health care for appropriate patientsLong term oral health care for appropriate patients

Shared care approachShared care approach

We We do notdo not provide specialist restorative, provide specialist restorative, orthodontic, oral surgery services or treatment orthodontic, oral surgery services or treatment under GA other than for patients that require under GA other than for patients that require special carespecial care

Making a referralMaking a referral

Standard KCLDI referral formStandard KCLDI referral form

Fully detailed referral letterFully detailed referral letter

Department of Community Special Department of Community Special Care Dentistry HQ at KingsCare Dentistry HQ at Kings