Practice abstract


British Dental Journal 205, 305 - 317 (2008)
Published online: 27 September 2008 | doi:10.1038/sj.bdj.2008.803

Subject Category: Special needs

Access to special care dentistry, part 7. Special care dentistry services: seamless care for people in their middle years – part 1

D. Lewis1, J. Fiske2 & A. Dougall3

  • The dental team needs to be familiar with the main features of rheumatoid arthritis.
  • For those with progressive neuromuscular conditions, instigation of rigorous preventive regimes and comprehensive restorative treatment is essential.
  • Patients with well controlled Type 1 and Type 2 diabetes can be treated similarly to non-diabetic patients provided that the normal regime of food, drugs and/or insulin is not disturbed.


Children and older people have been relatively well served by specialist dental care. Despite increasing disability amongst people in their middle years, there have been no or few dedicated dental teams with responsibility for provision of their oral care. This article explores the ethos and practicality of seamless care across the age groups and the primary/secondary care interface, with a focus on embedding oral health into general healthcare plans through the multidisciplinary team approach. The article explores four conditions – rheumatoid arthritis, Huntingdon's disease, multiple sclerosis and diabetes. It considers the features of each condition and how they can impact on both oral health and the delivery of dental services. It also considers the elements of care that contribute to a holistic and seamless approach to oral care services.

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  1. Senior Dental Officer in Special Care Dentistry, Dorset Healthcare NHS Foundation Trsut, Dental Department, Canford Health Centre, Poole, Dorset, BH17 9DW, Ireland
  2. Chairperson of the Specialist Advisory Group in Special Care Dentistry/Senior Lecturer and Consultant in Special Care Dentistry, Department of Sedation and Special Care Dentistry, King's College London Dental Institute, Floor 26, Guy's Tower, London, SE1 9RT, Ireland
  3. Lecturer and Consultant for Medically Compromised Patients, Division One/Special Care Dentistry, Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland

Correspondence to: J. Fiske2 e-mail: Janice.Fiske@gstt.nhs.uk




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