Special Care Dentistry is the newest dental specialty, recognised by the GDC in 2009. Special Care Dentists care for adolescents and adults with disability or impairment, which can be one of the following, or a combination of:

My journey into Special Care started when I was completing my Dental Core Training year. While my post didn't directly involve a rotation with the Special Care department, I kept encountering patients who needed adjustments to allow them to have their dental care done, or who found accessing dentistry difficult as a result of their additional needs. 

There was a pivotal moment for me when I saw a patient in a walk in emergency clinic who was homeless and who needed an extraction. He had tried to access 3 other dentists before coming to the walk in clinic, and he was refused care from all of them. Because of his toothache, he was continuing to self medicate with his drug and alcohol habits and clearly his oral health was having a huge impact on his overall health and well being. All I did for him was to take that tooth out, but I felt like that was the biggest achievement I had made in my career so far because I had never realised the impact we can have in our profession for our patients until then. 

This then led to me finding a job working in community where I knew that the problem solving and holistic care, not just the dentistry, were the reasons why I wanted to be a dentist.... so Special Care was the place for me! 

Patients with additional needs turn up in all fields of dentistry and we all have a responsibility under the Equality Act (2010) to make reasonable adjustments to care for patients who have protected characteristics. 

The main arenas for Special Care Dentists are the Community Dental Services (CDS) or Hospital Dental Services (HDS); however, seeing some patients with additional needs can be done in practice with the correct support and on appropriate risk assessment. Shared care between all 3 services is an arrangement that in many areas is being encouraged with good communication and team work. 

Not all hospitals will have a Special Care department and in some dental hospitals, Special Care is integrated with other dental specialities e.g. Restorative Dentistry or Oral Medicine. An important aspect to Special Care Dentistry is access to sedation and general anaesthesia. CDS therefore will not only have community based clinics, but often arrangements where theatre space is leased to have this access. Therefore many Special Care Dentists have a varied week, mixing between clinics, hospital and out in the community for outreach/domiciliary care or even mobile clinics (as pictured above). 

When progressing through a career in Special Care, generally there are 3 routes: a Specialising route, or progression through salaried jobs, or an academic route. 

Special Care Dentistry speciality training (ST) is generally 3 years in length and is recruited to nationally via applications through Oriel, currently once annually - although this may change. 

In order to be eligible for ST, generally you will need to have completed a DCT1 and 2 or equivalence post, have experience working in more than one speciality in dentistry and experience working with Special Care patients either in hospital or community. To see the full requirements, please refer to the COPDEND Personal Specification. 

Following completion of ST, this will allow work at specialist or consultant level in hospital or community. 

The SDS employ dentists to work within their service. To find out more what the SDS does, see this blog. 

Employed dentists will be employed according to the BDA's CDS contract and be either: