Access all areas: can your practice provide dental treatment for all? – Nina Cartwright

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  Posted by: The Probe      1st March 2018

 

The majority of people visit the dentist because they wish to look after and retain their natural teeth. This may be because they want to be able to eat easily and comfortably, to not be in pain, for their self-esteem and to look good.

There are also many reasons why people do not visit the dentist. These include dental anxiety, the cost of the treatment, and attributes of the interaction between the patient and the dentist. For example, in the Adult Dental Health Survey, 19% of adults aged over 16 years in England, Wales and Northern Ireland stated that they had delayed their treatment due to the cost, while 36% reported the reason to be moderate dental anxiety and 12% reported having extreme dental anxiety in relation to having a tooth drilled and/or a local anaesthetic injection[1].

However, for people who have a physical disability, it can be the case that they do want to visit the dentist but they are prevented due to factors that limit their access to the surgery (e.g. transport problems that cause missed appointments) or limit their treatment (e.g. discomfort when lying in the dental chair or pain when opening the mouth)[2]. For example, one study found that people who use a wheelchair do highly value oral health in terms of their smile aesthetics, but they reported severe difficulty in obtaining dental services, such as not being able to find an accessible clinic in the first place and coming across obstacles and cluttered spaces in the dental environment that make it awkward to manoeuvre[3].

According to the UK government’s official statistics, there are over 11 million people with a disability, impairment or limiting long-term illness, and the most commonly reported impairments are those that affect mobility, lifting or carrying[4]. Furthermore, disabled people are entitled to equal access to oral healthcare services and oral healthcare outcomes in terms of self-esteem, appearance, social interaction, function and comfort. The Equality Act 2010 that protects people from discrimination states that service providers have a duty to make reasonable adjustments to overcome barriers experienced by people who have a disability[5].

However, equal access does not currently appear to be happening[6]. Research indicates that disabled people have poorer oral health and there are barriers to using dental services; for instance, difficulty attending a dental appointment can arise from problems with physical entry to the premises (e.g. stairs)[7]. Their poorer oral health can be caused by their impairment (such as reduced manual dexterity or coordination in people with physical and neurological conditions that affects their brushing technique) and/or the side effects of medication (such as medicines that contain sugar or those that cause dry mouth)[8].

In a survey of English dental practices, 137 of 157 practices reported treating people who use a wheelchair but less than one third said that their practice was fully accessible (i.e. on the ground floor without steps or on the first floor with a lift, having sufficient door width and circulation space and with accessible toilets)[9]. A study that interviewed people who use a wheelchair consistently found that they experienced difficulties obtaining dental services due to problems with circulating inside the building and moving onto the dental chair. In addition, they stated that they preferred to stay in their wheelchair during the treatment [10].

So, what can be done in the dental practice to ensure that everyone has an equal ability to have to treatment? Physical access can be improved by, for example, providing designated parking spaces close to the practice, installing handrails and having ramps for wheelchairs. Regarding inside the practice, one solution is to install digital imaging equipment that enables a person to remain in their wheelchair during the imaging process.

One product that solves this issue is the CS 8100 panoramic system from industry-leading Carestream Dental. The CS 8100 unit’s height can be adjusted vertically so that it is suitable for patients who are standing or sitting, including for a person in a wheelchair. The CS 8100 fits easily into tight spaces and it makes the positioning of patients quick and simple. It is part of Carestream Dental’s CS 8100 family that was awarded the Dental Advisor’s ‘Top Panoramic Imaging System of 2014’, with a 99% rating and an Excellent Five Plus designation.

According to the World Health Organization, it is the responsibility of society to improve the access of people with different needs by removing the social and physical barriers to care so that there is obtainable, affordable and high-quality dental care for all[11]. One way in which you can contribute to this is by using equipment that is suitable for patients who use a wheelchair.

 

For more information please contact Carestream Dental on

0800 169 9692 or visit www.carestreamdental.co.uk

For all the latest news and updates, follow us on Twitter @CarestreamDentl and Facebook

 

 

 

 

 

 

[1] Nuttall N, Freeman R, Beavan-Seymour C, Hill K. Access and barriers to care–a report from the Adult Dental Health Survey 2009. The Health and Social Care Information Centre; 2011.

[2] Rashid-Kandvani F, Nicolau B, Bedos C. Access to dental services for people using a wheelchair. A J Public Health 2015;105:2312-7.

[3] Rashid-Kandvani F, Nicolau B, Bedos C. Access to dental services for people using a wheelchair. A J Public Health 2015;105:2312-7.

[4] Office for Disability Issues and Department of Work and Pensions. Disability facts and figures 2014. https://www.gov.uk/government/publications/disability-facts-and-figures/disability-facts-and-figures [Accessed November 2017].

[5] Equality and Human Rights Commission. What is the Equality Act? https://www.equalityhumanrights.com/en/equality-act-2010/what-equality-act [Accessed November 2017].

[6] Dougall A, Fiske J. Access to special care dentistry, part 1. BDJ 2008;204:605-16.

[7] Arnold C, Brookes V, Griffiths J, Maddock S, Theophilou S. Guidelines for oral health care for people with a physical disability. British Society for Disability and Oral Health. http://www.bsdh.org/documents/physical.pdf [Accessed November 2017].

[8] Dougall A, Fiske J. Access to special care dentistry, part 4: education. BDJ 2008;205:119-30.

[9] Edwards DM, Merry AJ. Disability part 2: access to dental services for disabled people. A questionnaire survey of dental practices in Merseyside. BDJ 2002;193:253-5.

[10] Rashid-Kandvani F, Nicolau B, Bedos C. Access to dental services for people using a wheelchair. A J Public Health 2015;105:2312-7.

[11] Rashid-Kandvani F, Nicolau B, Bedos C. Access to dental services for people using a wheelchair. A J Public Health 2015;105:2312-7.

 


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