A little boy with a big smile

😄"Be kind to dentists … they have fillings too", 😄 "Don’t rush when you brush", 😄"Smile, it raises your face value". A little light humour to relax the mood as it is a well-known fact that many people dislike going to the dentist.

Part of being healthy is looking after your teeth and gums and this includes regular visits to the dentist even if it is not something you like to do!

Building good dental practices from an early age is ideal for people with a disability, but it is never too late to begin looking after your teeth and gums. Simple treatments and good dental hygiene can help to prevent larger and more complex issues, need for extended care and dental costs.

In this article IDEAS takes a closer look at dental care:

Steps to Good Dental Health | Dental Care Tips | Some Common Issues | Resources, fact sheets and social stories | Special Needs Dentistry | Finding a Dentist | Costs | Dental Services |

Steps to Good Dental Health

There are many things that can help people with a disability to have good dental health:

  • Accessible dental information
  • Following a dental care routine
  • Finding more sensitive or easy to use dental products
  • Support workers or carers helping with dental care
  • Strategies to manage fear or discomfort about visiting a dentist
  • Building a good relationship with a dentist
  • Regular visits to a dentist
  • Using dental benefits schemes

Prevention is ideal and can be achieved with good dental health care and regular visits to the dentist. IDEAS is however aware that waiting lists for public dental health services and costs of dental care can be an issue for some people with a disability.

Dental Care Tips

🙂 Looking after your teeth at home

  • The best way to avoid extended visits to the dentist is to have good dental care routines at home.
  • A healthy diet is a good place to start with dental care. Limiting sugary drinks and foods is a good idea.
  • The best drink to have is water, especially with and after meals.
  • A routine of morning and evening brushing and flossing of teeth can help everyone keep a track of their teeth care.

🙂 Check-ups at the dentist

  • Regular check-ups are essential to good dental health.
  • The recommendation is for every 3-6 months for cleaning off plaque and tartar, and treating with fluoride
  • Cavities and gum issues can be noticed early to promote quick treatment

Some Common Issues

Things to look out for:

  • Some people grind their teeth so it is something a dentist will need to monitor
  • If swallowing is an issue, food can stay around the teeth and cause decay. Pneumonia is also a risk as people can breathe food into their lungs
  • Dry mouth problems can arise from certain medications and the lack of saliva can increase the risk of decay and gum disease
  • Gastric reflux and acid from the stomach can get onto teeth and the tooth enamel is worn away. This may lead to hypersensitive teeth and if left unattended to complex and expensive repairs
  • Malocclusions (protruding lower or upper teeth) may cause eating problems and the treatment with regular braces may not be suitable. A talk with a dentist will make treatment options clearer

 Sensitivities to Toothpaste and Toothbrushes

  • A heightened gag reflex of people with a dislike of the taste of mint or other strong flavoured toothpaste may mean looking for flavourless brands. Searching ‘flavourless toothpaste” will locate a variety of brands suitable for people who need them
  • The gritty and grainy texture of some kinds of toothpaste can make some people reluctant to brush their teeth. The alternative may be a gel that has a smoother feel to it
  • The foamy froth produced when brushing can be a problem for people with sensory issues. Low or no foaming pastes may solve this
  • For people who don’t like the feel of the brush on their teeth try using the softest type. Some children with autism enjoy the feel of the vibrations of an electric toothbrush
  • It may be a case of trial and error when working out what toothpaste and toothbrush are most acceptable. What is more certain is that good oral hygiene will lessen future dental problems

 Special Needs Dentistry (SND)

Special Needs Dentistry (SND) is defined by the Royal Australasian College of Dental Surgeons as “the branch (of dentistry) concerned with the oral healthcare of people that require special methods or techniques to prevent or treat oral health problems, or where their conditions necessitate special dental treatment plans.” For a service to offer SND, they must have excellent disabled access as a minimum standard. They also undertake specific training and ongoing professional development. They may also have other people in their clinic that are trained to support people with a disability such as dental nurses or hygeinists.

Teenager in a wheelchair having his mouth examined in a dental clinic by a dentist who is wearing a mask

There is a shortage of special care dentists for people with a disability. However, not everyone needs a specialist, especially if dentists are prepared to accommodate the needs of the people they are attending to.

The Your Dental Health team found that 'interdisciplinary consultation – coupled with a modest amount of disability sector knowledge – can lead to significantly smoother treatment, the removal of barriers, and wonderful health outcomes for people with intellectual disability.'

Finding A Dentist

If you are looking for a private dentist, ask around your network. Other families, disability services or your GP may know a dentist with the right skills. Some things to consider:

  • what kind of people the person with a disability is relaxed with
  • is the person more comfortable with men or women
  • can you visit the clinic first before deciding if you want to go ther
  • time of day the appointments can be made
  • can treatments be done in your wheelchair instead of transferring to a dental chair
  • do they have other patients with a disabilitycosts and payment options

 A link to some services is provided below.

Resources and social stories

Helping people to understand dental health care and what to expect when going to the dentist can help to make things go more smoothly. This may be especially important for people with intellectual disability, autism or those who may have anxiety.

Planning to go to the dentist. A guide for families and carers of people with autism
This booklet aims to provide some knowledge on how to prepare for the dental visits and some tips maintaining good oral hygiene habits at home.
It includes tips for helping with teeth brushing, making the dentist visit more comfortable and supporting someone at the dentist.
Download - DDWA-Dental-Guide

Going to the Dentist - An Easy Read document that shows what a dentist visit is like.
Download - dentist_story

The Council for Intellectual Disability has fact sheets relevant to dental care and going to a dentist.
Download:        Dental care here         Going to the dentist here

Mouth Care - _guide_for_carers.pdf

Your Dental Health: A Guide for People with Disability, their Family, Carers, Friends and Advocates  
It is presented in an English and Easy Read English format.
It is a guide written for Australians with intellectual disability that outlines how to look after your teeth and gums. It demystifies dental care, introduces people to public and private options, and tells you what to expect during a visit to the dentist.
Download - IM-Dental-Health-Publication

Dentist


Whether it is a mild case of worry or anxiety, or a serious phobia or fear, many people avoid going to the dentist. Dental Phobia: How to overcome fear of the dentist is an ABC Health program that helps to explain these feelings. 

Please note that the factsheets and resources contain general information only and does not take into account individual circumstances. It should not be relied on for medical advice. Readers are encouraged to look at the information in this fact sheet carefully and talk with their health professional to decide whether the information is right for them.

Going to the Dentist

Some tips that might help when going to the dentist

  • Explain in advance what needs you have and what will help
  • Do the paperwork beforehand if you can
  • Ask a support person, friend or family to go with you
  • Call ahead to see if your appointment is running on time
  • Bring a book to read while you wait and to distract you
  • Bring sunglasses to cut down on the glare of the bright surgery lights
  • Listen to music to block out the sound of the instruments used on your teeth
  • Bringing a soft toy or comfort item
  • Ask to have follow up information written out clearly or in Easy English
  • Book your next appointment

Costs

The Government does not cover the costs of most dental services in the way it does with other health services. Most dental costs are paid for by patients.
Medicare does, however, pay for some essential dental services for some children and adults who are eligible.

The Child Dental Benefits Schedule covers part or the full cost of some dental services for children if you get certain payments.
To get this your child must be:

  • 2 to 17 years old for at least 1 day that year
  • eligible for Medicare
  • getting a payment from the Australian Government at least once a year, or have a parent getting a payment from the Australian Government at least once a year.

The benefits are capped at $1,000 per child every two years and they cover services such as examinations, x-rays, cleaning, fissure sealing, fillings, root canals and extractions.  Information can be found at: Child Dental Benefits Schedule  

Public Dental Services 

The states and territories provide public dental services both for children and adults. These may include emergency dental services or referrals to specialist services like orthodontics in hospital. Adults must generally have a Health Care Card or Centrelink Pensioner Concession Card to be eligible, although the rules vary depending on where you live.

Each state and territory offers different services and you may have to wait up to a year or more to see a dentist. To find out what’s available where you live, visit your state or territory health department website.

Private Health Insurance

This may help with the costs of some dental care. It is good to shop around for insurance. Check the full details before joining up including what is covered and not, the costs and what services you can use.

Dental Services

We have listed some services.

Public dental clinics in NSW

Many people with intellectual disabilities attend public health clinics. There are many clinics located in NSW and they do not charge. Unfortunately, they usually have long waiting lists and some of the dentists aren’t knowledgeable about treating people with special needs. To go to a public dentist an appointment will need to be made.

The receptionist will ask some questions to work out what treatment is needed, and therefore what priority to give the person. It is also a good idea to write down a list of signs to describe a person’s dental problems.

  • Discomfort or pain when eating or drinking hot or cold items
  • Reluctance to brushing or having their teeth brushed
  • Do they have bleeding gums?
  • Do they have bad breath?
  • Unusual or erratic behaviour may indicate that a person is in pain

If someone has to wait for six months for an appointment and this is considered too long, then it’s important to speak up and request a closer time.
A person in pain must be given priority.
The need for sedation or a general anaesthetic must be made known at the time of making the appointment.

Specialist Public Clinics in NSW

Westmead Centre for Oral Health -  The Western Sydney Local Health District has two community dental clinics at Blacktown Hospital and at Mt Druitt Hospital that provide public oral health services to the local eligible population and patients from around NSW.

Sydney Dental Hospital Special Care Dentistry Department

NSW Health South Eastern Sydney Special Needs Dental Clinic

Eligibility criteria:

  • Assessed as unsuitable for the mainstream public dental service, and
  • Aged 16 years and over, and
  • meet homelessness or drug and alcohol or mental health criteria

The clinic is co-located within the Mission Australia Centre Surry Hill. It has dentists, dental assistants and a welfare officer who provides coordination, administration and promotion of the dental service, as well as counselling and support for clients. 

Private Dentists NSW

Some private dentists are experienced with people with disabilities but they do charge fees. If you have private health insurance this may cover part of the fees.

Northside Dental and Implant Centre at Turramurra and Hornsby.

Mind Body Teeth at Wahroonga.

The Special Needs Dentistry Practice This business has locations at Bondi Junction, Crows Nest, Willoughby and Miranda. Each location is wheelchair accessible and the rooms are large enough at the Crows Nest, Bondi Junction and Miranda practices to see patients in their wheelchairs, even if they are large. It is preferable to attend the Crows Nest practice which has a patient hoist to transfer from a wheelchair to the dental chair for optimal dental treatment.

Dental Services in Victoria

Public Dental Services

Services for Homebound Patients In-home services are for housebound patients who cannot leave their homes, whether due to a medical, physical, or mental condition. Aged-care patients for whom travel to the hospital may pose particular risks can use this service. Those who do not have a valid concession card will have to pay a fee.

Mobile dental services
Mobile dental services are provided through Dental Health Services Victoria with two special needs vehicles. They travel to special schools and special development schools in Victoria and provide general dental care to children with physical and intellectual disabilities. Children who attend a special school or special developmental school in Victoria can receive free dental care every one to two years.

Hospital settings
The Special Care Unit at the Royal Dental Hospital of Melbourne provides dental care to patients with special needs who need dental treatment in a hospital setting. You will need a referral for treatment at the Special needs care unit.

Additional high needs dental services
Dental treatment is provided at Oznam House for people who are homeless. General dental care and denture care is available.
For further information, please call:

  • (03) 9341 1000 Melbourne metro area
  • 1800 833039 Outside Melbourne metro area

To complete a referral application click Specialist Services Referral Form

Private Dentists Victoria

Western Special Needs Dentistry Niddrie
This is a specialist practice for people with special needs located in the western suburbs of Melbourne.

Special Needs Dental Located in Blackburn, east of the Melbourne CBD.

Public Dentists WA

Special Needs Dental Clinic – a purpose-built special needs clinic operates in North Perth, providing dental services to those who meet eligibility criteria.

Public Dentists SA

SA Dental Service provides a range of services for adult clients with special needs. Community Dental Service clinics may refer adult clients with physical and/or intellectual disabilities to the Special Needs Unit at the Adelaide Dental Hospital.

Public Dental Services in other states and territories


IDEAS does information so you can do life.