Why Should Special Care be Included in the Undergraduate Curriculum with Mala Sabharwal
So after an overwhelming response from my most recent blog competition, here is one of the runners-up blog entries by Mala Sabharwal, a fourth year dental student at Kings College London...
Special Care dentists treat patients that cannot receive routine care from a general dental practitioner due to their physical, mental or medical condition and they may have further needs that need to be accounted for.
To put the importance of special care into perspective, one billion people in the world have a disability and this number is increasing as time goes on. In addition, we are seeing a growing and ageing population within the United Kingdom, where naturally, age-related disability come into play. Within the United Kingdom, 25% of disabilities are mental health related. This constitutes a significant amount of the population who may be missing out on dental care as the individual may feel there are barriers to being able to access what they need.
''1 in 4 people in the UK have mental health issues.''
With patients feeling there is a barrier, dentists in training should have some idea of how best to manage the situation. Special Care modules can teach undergraduates to account for the additional needs the person may have and adapting the treatment in accordance with this. It teaches the undergraduate an element of thinking outside the box and problem solving as each patient will present with their own subset of increased needs.
By incorporating special care into the curriculum, fresh graduates will be better equipped to handle each scenario and this could ultimately decrease the number of referrals to special care settings as they may feel that they have the skill set and equipment to do what is in the patient’s best interests. From simple knowledge, such as knowing how to appropriately modify delivery of oral hygiene instruction and what it includes, to being aware of what signs to look out for when a patient presents to the dentist, who may not necessarily disclose certain conditions. By getting students involved in a timely manner within the course and getting exposure to the clinical scenarios early on, they can become invested and pursue the speciality later down the line as they can better appreciate the importance. As time goes on, more special care dentists will be needed as there will be increased patients with additional needs.
Qualified dental practitioners have indicated that insufficient undergraduate education within the discipline contributes to one of the reasons they they would be less likely to treat this cohort and so increased education is imperative to increase the confidence of the practitioner and ideally reduce inequalities of dental care due to disability.
Another issue to address is the elephant in the room in the form of COVID-19. Unfortunately, with everything the pandemic has caused, another barrier has been created in accessing dental care. Individuals who are more vulnerable may feel sceptical about attending the dentist as they may prefer to shield and individuals who suffered with anxiety before the pandemic may feel this way even more now. In this way it is crucial for undergraduates to have special care ingrained in the curriculum to understand how to manage these patients.
As we go on and adapt in the world with an ongoing pandemic, these patients may have further increased needs as it may take time to get them into the dental chair with the limited slots due to accommodating for fallow time from aerosol generating procedures, so the dentist in training should be ready to plan for their patient with a calm and holistic approach. This applies to whilst they are in training and once qualified as a lifelong skill. Ongoing dental research, linked to COVID-19, has indicated the importance of optimal oral healthcare with some potential links to recovery from the disease.
Therefore, it is of upmost importance newly qualified undergraduates are equipped to deal with as wide of a demographic, as possible, whilst also working within a multi-disiplinary team to act in the patient’s best interests according to the General Dental Council’s standards.
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