Autism And Learning Difficulties – Dental Guidance Given
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- Published: Friday, 21 May 2021 10:36
- Written by Chris Tapper
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The Chief Dental Officer of England has issued guidance on helping people with autism and learning difficulties with their oral health.
In the latest NHS dentistry and oral health update, Sara Hurley highlighted that that people with a learning disability generally have higher rates of health problems than the general population and that these may go undetected and untreated.
Dr Hurley said “This is certainly the case for oral health, where evidence shows greater unmet oral health needs, poorer access to dental services and less preventive dental interventions.
“And for those patients who require referral into secondary Special Care Dental Services there may be waiting times which mean primary dental care will continue to support the patient.”
She said that autistic patients may find the experience of a dental examination itself, distressing.
Dr Hurley added “Many patients with a learning disability, and those with additional support needs, can be successfully supported to achieve better oral health in primary dental care. They may need reasonable adjustments, such as additional time, accessible and focused pre-appointment information, clear communication with the individual and carers and support to manage anxiety or other issues that may impair their ability to engage with the assessment and treatment process.”
The advice given in the update outlined the high-risk factors that may lead to poor oral health in these groups, including previous treatment under general anaesthesia, high sugar diets as a result of consuming high-calorie nutritional drinks and frequent medication in liquid form.
The guidance, written in collaboration with Dr. Roger Banks, NHS National Clinical Director for Learning Disabilities and Autism also stresses the need to warn such patients of the changes in the dental practice that have been brought in as a result of the pandemic.
The update warns “There is a legal obligation for dental services to make reasonable adjustments to ensure that their patients with a learning disability can use their service in the same way as other people. This might include making practical adjustments to the environment or changes in the process.”
To help practitioner’s, Public Health has produced a booklet ‘Oral Care and People With Learning Disabilites,’ which can be found here.
The guidance says “People with a learning disability may not say they are in pain. They may not act in a way that you would expect people in pain to act. It might be difficult to know if someone is in pain if they do not communicate verbally. People who have additional health needs, especially those who are immobile or use a wheelchair, are likely to suffer from long-term pain.”
“Sometimes when people are in pain they may display distressed behaviour which presents as challenging– this might include trying to hurt themselves or others. Other people may become quiet or withdrawn or they may show unusual behaviours like laughing or crying. This sort of change in behaviour should not just be assumed to be because they have a learning disability. They might be showing that they are in pain. Understanding what is ’normal’ for that person by talking to them, their family and carers, is crucial to helping with assessment and diagnosis.”
“Some people believe that people with a learning disability can tolerate more pain than the general population. This is not true. People with a learning disability, like non-disabled people, will have individual and different responses to pain. It is important not to treat everybody with learning disabilities as though they can cope with a lot of pain.”
Public Health England and the Department for Health and Social Care’s Delivering better oral health: an evidence-based toolkit can be found here.
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