Why Should Special Care be Included in the Undergraduate Curriculum with Aurelia Claudia

So after an overwhelming response from my most recent blog competition, here is one of the runners-up blog entries by Aurelia Claudia, a final year dental student at Newcastle University...

 


What is Special Care Dentistry (SCD)?

It is a field of dentistry that specifically aims to improve the oral health of people who have been affected by physical, medical, intellectual, social, psychiatric issues, or often a combination of them. SCD involves a broad scope of practice, yet dental students are still predisposed to thinking that we are not going to handle this group of patients. I should admit that I was one of them. In the four years of my dental education, I have not been taught much about SCD. When an alumnus from my university spoke about SCD in a conference, and I was beginning to see the relevance of SCD in daily practice. Here are the reasons why I believe SCD should be part of the undergraduate dental curriculum.


1. Increasing prevalence of people needing SCD in practice

There are 11 million people who have limiting long term illness, impairment, or disability in the UK. This represents one-sixth of the whole population! Although this subject is considered a speciality training, the number of people needing special care in dental settings are rapidly increasing. Some people have an apparent functional impairment, but we often forget that not all impairment are visible. Others from the marginalised group face difficulties accessing dental treatments. These patients' needs are often overlooked. Understanding the inequalities, external influence, and how they can impact oral health could revolutionise young dentists' approach in their clinical practice and career choices. 

A patient with partial hearing impairment appears as an ordinary-looking person with no apparent physical disability and would access a regular dental clinic. Small adjustments, such as opening mask when speaking to patients, enable lip reading and could help you communicate effectively with the patient. Other patients, such as an elderly patient who consumed 11 tablets for his medical conditions or a child with trichotillomania, would need special consideration in their care to truly and effectively improve their oral health. Guess what? They are patients I have treated in a short 1.5 years of clinical experience as an undergraduate student. Do we still think that us, young dentists, would not encounter these patients daily? Special care patients encompass a vast spectrum, and we will meet many of them throughout our career. So, I encourage you to think again. 


2. To standardise the education and clinical training of dental undergraduates across the country

Special needs patients require a holistic approach to their care, such as some behavioural management, rather than focusing on specific dental treatment. Fortunately, I received constant support from the clinicians on my patients who require special care. However, I discovered that these valuable lessons are not well distributed in the whole cohort as everyone has a different type of patients. Therefore, SCD incorporation into the dental undergraduate curriculum is needed to standardise our knowledge, skills and attitude when treating special care patients. We are the future of dentistry who need to play our part in ensuring that the patients receiving the best care wherever they get their teeth checked. This effort could reduce dental anxiety many special care patients' experiences in the long term.


3. To diminish the oral healthcare inequalities experienced by the marginalised groups

Despite the decreasing prevalence of oral diseases such as caries, periodontal diseases, or oral cancer, not every part of the country is experiencing the same rate of reduction. People who are disabled and of lower socioeconomic status tend to have poorer oral health. The major contributors are the lack of access and education received by this demographic. While Public Health England and the government have built schemes in attempt solving these issues, it is all not going to work entirely without dental students' efforts. 


I found educating patients as a dental student challenging as patients do not necessarily listen. However, I eventually learned that gaining an understanding of patients' socioeconomic challenges and giving them tailored oral hygiene instruction was game-changing! My arthritis patient was more willing to listen and showed improvement on the plaque scores after I asked a dental technician to make a better toothbrush handle. If I had considered the barriers and consider inter-professional help earlier, my patient could benefit sooner. 

SCD in the undergraduate curriculum means we can be better dentists who have adequate knowledge, skills, and behaviour to treat patients with diverse background and complex needs. More people can have a better experience with general dentists before they are referred to specialists if needed. It is no longer justifiable to tolerate this missing component in our training to be the future dental professionals when the consequences are going to cost our patients. 

After all, SCD is about preparing us, dental undergraduates, as equity to achieve equality in dentistry. That is the least we should do to respect and serve our patients their human rights.



What an amazing entry! Congratulations Aurelia on your informative and brilliant piece!

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3 comments

  1. Awesome post!! really enjoyed reading �� �� and totally agree that SCD is a necessity at undergraduate level :)

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    Replies
    1. I agree! Great post and message! Look out for the other runner up soon!

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    2. Thank you for your nice comment :) I am glad you enjoyed it!

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