scd specialist services presentation
TRANSCRIPT
Specialist Special Care Dental Servicesin Birmingham
… for patients with disabilities, medical or mental health problems
Introduction The speciality of Special Care Dentistry (SCD) is concerned
with the care management issues that arise in adults with severe disability, medical or mental health problems who require general dentistry.
This presentation is about the Specialist SCD services available to dental and medical practitioners with HOB, BEN and SB PCT contracts.
Contact us: [email protected]
phone 0121 465 5380 fax 0121 465 2929
Kenneth Wilson: Consultant lead for Mental Health and Older Persons/GerodontologyNick Ransford: Consultant lead for Medically Compromised patients and SedationBarbara Simpson and Lisa Hayden, Specialist Dental Nurses
3 SCD services are available
1. SCD Query Service For specialist advice on dental care for adult patients with
disability, medical or mental health problems
2. SCD Specialist Referral Service For referrals of adult patients with the most complex dental care
management problems
3. SCD Educational Programme For verifiable CPD on practical aspects of SCD for patients
treated in General Practice
1. SCD Query Service
FAQ examples:
Is it safe to treat this patient, with this medical history, in my practice?
How can access be made easier for patients with limited mobility?
How are this patient’s mental health related problems best managed?
But this patient won’t even sit in the chair and open their mouth!
What precautions should I take with condition X or drug Y?
How do I use the SCD Query service?
Download and complete the SCD Query form
Please give full information
email, fax or post
Your reply will be dispatched within 3 working days
2. SCD Specialist Referral Service
2.3 Adults with severe disability or multi-system disease
2.4 Adults with severe mental health problems
2.2 Adults with ASA III / IV medical conditions
… for four groups with complex needs
2.1 Adults requiring IV sedation who would otherwise need GA
2.1 Adults requiring sedation who would otherwise need GA
Examples Behavioural issues:
severe learning disability, autism, dementia
Involuntary movement disorders: cerebral palsy, Parkinson’s
2.2 Adults with ASA III / IV medical conditions*
Examples Unstable cardiac disease:
angina, arrhythmia
Severe respiratory disease: COPD, asthma
Unstable circulatory disease: uncontrolled hypertension, recent stroke/ TIA
Unstable epilepsy or diabetes
* American Society of Anaesthesiologists’ Classification of Physical Status. ASA III / IV conditions often incur frequent systemic symptoms, prevent physical activity such as climbing stairs, require multiple medications to control, and may have resulted in recent acute episode(s). They pose significant risk of a medical emergency and may require treatment in a hospital environment.
2.3 Adults with severe disability or multi-system disease
Examples
Severe neurological disorders: multiple sclerosis, brain injury
Severe chronic inflammatory disease: rheumatoid arthritis, lupus
Significant risk of bleeding or healing problems: dialysis,liver disease, immunosuppressed, IV bisphosphonates
2.4 Adults with severe mental health problems
Examples History of harm to
self or others
Unstable psychotic illness
Extreme dental phobia
Please note
Patients with less complex special care needs should be referred to the Birmingham PDS via Janet Clarke’s Office: Birmingham PDS, CIBA Building, 146 Hagley Rd, Birmingham B16 9PA, phone 0121 255 0546
Children under 16 requiring specialist care should be referred to a Consultant in Paediatric Dentistry
Adults requiring advanced surgical or restorative care should be referred to a Consultant in Oral Surgery or Restorative Dentistry.
How do I use the Specialist SCD referral service?
Download and complete SCD Specialist Referral Form
Email, fax, or post
Treatment started within 18 weeks
Shared continuing care in appropriate cases
3. SCD educational programme
Typical SCD topics: Common medical conditions: how to assess risk and prevent
problems
Communication, consent and clinical holding
Management of bleeding and healing risks
Practical dental solutions for patients with progressive disabling conditions
Management of problems related to mental health conditions
Sedation in SCD patients
How do I access these courses?
Via the Workforce Deanery West midlands website, go to education and development, dental courses, section 63 timetable
Contact your postgraduate tutors re local PLT sessions
See local BDA meetings programme
Contact us via [email protected]
We look forward to seeing you there.