Oliver McGowan Mandatory Training on Learning Disability and Autism

People with learning disabilities and autism access routine dental care in all settings. It is important that healthcare staff support and care for these people in a safe, respectful manner, providing reasonable adjustments when necessary to deliver informed care. The Health and Care Act 2022 requires that Care Quality Commission-regulated services ensure all staff undertake training in learning disability and autism. The Oliver McGowan Mandatory Training was brought about by the death of a young man with autism in an NHS hospital.

The training is split into two tiers: Tier 1 for those whose roles require general awareness to support those with learning impairments or autism; and Tier 2 for those who provide care, and is a mix of online interactive sessions and face-to-face teaching. The training is made up of best current practice in addition to the knowledge and experiences of people with learning disabilities and autism, and those who care for them. By undertaking this mandatory training teams can develop skills and the confidence to deliver equitable, compassionate care, and understand the needs of those with learning disabilities and autism.

Health Education England (2023). Available at www.hee.nhs.uk

 

Dental student readiness to treat special care patients upon graduation

This observational, cross-sectional, questionnaire-based study looked at the responses of final-year dental students across two universities (the University of Aberdeen and Universitat Internacional de Catalunya) regarding their perceived readiness to deliver care to special care patients upon graduation. Although a small sample size responded to this survey, the students strongly agreed that special care dentistry (SCD) should be an integral part of the undergraduate curriculum.

Most felt that the theoretical teaching was sufficient, but that the practical application of this was lacking. Most students wanted “more exposure” to SCD patients in a variety of settings, including hospital, community and domiciliary locations.

Students felt confident to provide care for elderly patients, but significantly less so to those with learning disabilities, physical disabilities or those who were medically compromised.

The authors concluded that students preferred case-based and problem-based teaching over traditional lectures to increase their confidence. Teaching methods that encouraged interaction and exposure improved their experiences in SCD.

López RM, Bovaird I, Olmo González B, Abu-Eid R. Spec Care Dent 2023; 1–14  

 

Top tips for supporting patients with a history of psychological trauma

Over 70% of people will experience a traumatising event, and a number of these people can develop psychological and physical responses to this trauma. Delivering dental care for these patients can be challenging for patients and clinicians as these experiences can manifest in a variety of ways within the dental setting – fight, flight or freeze. This article discusses the importance of being aware of the presentations of trauma, including dissociation and how to manage these episodes if they do arise. It also details how to respond to disclosures, appropriate language to use and the five principles of delivering trauma-informed care (choice, collaboration, trustworthiness, empowerment and safety). The dental team should be aware of local services and available resources, and be able to offer referrals to mental health services if required.

Gunter E, Sevier-Guy LJ, Heffernan A. Br Dent J 2023; 234: 490–494

 

Caries management in special care

Patients with learning disabilities or additional needs often have a high caries rate due to difficulties accessing care and carrying out optimal oral hygiene as the result of socioeconomic, behavioural, psychological and physical factors. These can present challenges for the patient, clinician and support team. This paper advocates a modern caries management approach, utilising a patient-centred, risk-based strategy of early caries detection and use of materials that remineralise or arrest decay. It’s important to reassess risk and modify variables such as diet, provision of oral hygiene and fluoride use. Therapeutic options highlight nonrestorative and preventative measures, including the use of silver diamine fluoride, fissure sealants, sodium fluoride varnish and toothpaste. Minimally restorative techniques are discussed that facilitate plaque control and limit caries progression: atraumatic restorative technique, improving cleansability and selective caries removal to allow a coronal seal. The authors summarise with the importance of creating an individual caries-prevention plan for both short- and long-term management, and encouraging adaptation of the modifiable factors and increasing prevention.

Campos MS, Fontana M. Dent Clin N Am 2022; 66: 169–179