Provision of dental care for special care patients: the view of Irish dentists in the Republic of Ireland.

Abstract

Part 2 of the Disability Act 2005 requires that all people with a disability are entitled to a needs assessment and, by implication, provision of identified care needs. This process started with children aged 0-6 in 2007 and will roll out to all people with disabilities by 2011. Oral health is part of that needs assessment but it may be that dentists are not in a position to provide that care, by virtue of a lack of education, training or facilities. The majority of dental care delivered would seem, from information gathered as part of this study, to be of an emergency nature. This study aimed to identify the shortfalls in service provision, and their potential causes, to inform what it is hoped will be a positive directive on special care dentistry (SCD) in the proposed National Oral Health Strategy.

To assess the provision of dental services for special care patients (SCPs) by dental practitioners in Ireland. To review the educational background of primary dental care providers in SCD.

A postal and online questionnaire was sent to every third dentist on the Dental Register in Ireland. An analysis of data was performed using Statistical Programme for Social Sciences (SPSS).

There were 782 questionnaires distributed. Of the 274 (35% response rate) dentists returning questionnaires, 236 were deemed suitable for inclusion; those dentists working in general practice or the Health Service Executive (HSE) only were included. Treatment provided by dental practitioners included emergency services (775), extractions (72%) and restorative intervention (72%). Oral hygiene instruction for the carers of SCPs was provided by 52% of respondents. Of those surveyed, 25% claimed an awareness of the Disability Act 2005. Qualitative analysis of a definition of SCD and the perceived barriers to care were recorded. Additional fees for the treatment of SCPs were deemed necessary by 78% of respondents. An experience of training in SCD was recorded by 41%, and 65% of dentists expressed a willingness to partake in some/further training.

While the treatment of SCPs was reported by the majority of respondents (66%), the most common service provided was the management of dental emergencies. The need for a greater emphasis on preventive care was highlighted. Knowledge of the Disability Act 2005 was limited and responsible agencies need to increase awareness of the requirements for professional groups, like dentists, under the Act.