David’s story

David has complex learning disabilities, autism and additional healthcare needs. He is non-verbal, uses a wheelchair and relies on carers to support all aspects of their healthcare, making routine dental appointments particularly challenging.

David has attended regular dental appointments but because of his complex needs, it was difficult to carry out a full dental examination in the clinic.

We have been trialling routine dental examinations within a number of care homes. Providing care in a familiar environment helps reduce the challenges associated with travelling to appointments and supports patients who may struggle to tolerate a clinical setting.

A home visit meant our team was able to complete a more thorough examination than had previously been possible. We established that David had dental problems that required treatment under general anaesthetic which would allow a full assessment and any necessary treatment to be completed safely in a single admission.

Planning for the procedure involved close collaboration between the dental team, carers and the anaesthetic team. Previous medical records were reviewed to ensure the patient’s individual anaesthetic needs were fully understood, and discussions were held with David’s family so they could be involved in decisions about their care.

David’s carers also raised concerns about an unrelated health issue. It is standard practice to consider whether other necessary investigations can be completed while a patient is already under general anaesthetic, the CDS-CIC team contacted the patient’s GP. This resulted in additional investigations being arranged and carried out during the same hospital visit, avoiding the need for a separate procedure and another general anaesthetic.

While under general anaesthetic, David had a full dental assessment, multiple tooth extractions and restorations, treating dental disease that could otherwise have caused pain and infection. The additional medical investigations requested by the GP were also completed before the patient recovered from the anaesthetic.

Following treatment, the family received reassurance from the results of the additional investigations and shared positive feedback about the care their relative had received.

For the CDS-CIC team, David’s story demonstrates the importance of adapting dental care to meet the needs of patients with complex healthcare requirements. By providing care in a familiar environment, working closely with carers, family and other healthcare professionals, and coordinating dental and medical investigations during the same hospital visit, we were able to reduce the number of appointments and anaesthetics David needed while ensuring his dental health was appropriately managed. This collaborative approach helped provide safe, person-centred care while giving David’s family greater reassurance and confidence in his ongoing care.

To protect patient confidentiality, all patient stories have been anonymised. Any images used are stock photographs for illustrative purposes only and do not depict actual patients.