Best practice models for dental care delivery for people experiencing homelessness.

People experiencing homelessness have been encountering significant barriers in accessing healthcare services, including dental care services. There are several definitions for homelessness: it includes people sleeping rough but also people living in temporary accommodation. These categories are dynamic and individuals often find themselves on a continuum oscillating between sleeping rough and living in temporary accommodation. Their health-seeking behaviours are shaped by their living arrangements; therefore, one single model of dental care service delivery might not capture the needs of all those experiencing homelessness within an area. The service models presented in this paper are based on primary care delivery, mobile dental units and community clinics. Each of these models presents advantages and disadvantages and consideration should be given to delivering these on a complementary basis to maximise access to dental care, regardless of where patients are on the continuum between sleeping rough and living in temporary accommodation.

Models of dental care for people experiencing homelessness in the UK: a scoping review of the literature.

Background People who experience homelessness have poor oral health and face barriers to accessing care. Recommendations have been outlined for health services to address their needs, termed 'inclusion health'. The Smile4Life report recommended three 'tiers' of dental service: emergency, ad hoc and routine care. Other medical services have developed into different models of care, for example mainstream practices with enhanced services for people who experience homelessness. There is little understanding of how inclusion health recommendations have been implemented across dental settings.Aims To describe and compare dental services that exist for people who experience homelessness in the UK.Methods Two Medline searches were performed in October 2020 to assess the models of dental care for people who experience homelessness in the UK.Results Nine dental services in the UK were identified who treated people who experience homelessness. Most did not explore definitions of homelessness. There were a mixture of models, including using blended approaches, such as different sites and appointment types, to flex to the needs of their population.Conclusion Many services that are dedicated to treat this population are based in the community dental services which allows for flexible models of care due to sporadic patient attendance, high treatment requirements and complex needs. More research is required to determine how other settings can accommodate these patients, as well as understanding how more rural populations access dental care.

Dental management of patients with sensory impairments.

This article discusses the different types of sensory impairments and their aetiology. It considers how the oral health status in patients with sensory impairments is impacted by their disability and the barriers these patients face in dental care. It also discusses legislation relevant to dental care professionals when caring for patients with disabilities, including the Mental Capacity Act (2005), the Equality Act (2010) and the Accessible Information Standard (2016). Finally, it provides recommendations to dental care professionals on how they can best manage patients with sensory impairments and communicate with them effectively in order to provide them with quality dental care.

Why should everybody care about special care dentistry?

Special care dentistry (SCD), one of 13 dental specialties, is the most recent addition to the GDC Speciality List, in 2008. Yet, SCD is often an area which dentists and dental care professionals only encounter via referral or directly within a secondary care or community dental setting. At undergraduate level, though a listed aspect of the GDC's curriculum, experiences within special care departments are often limited. Additionally, with other specialties such as restorative dentistry taking precedence, there is a risk of SCD being viewed as an adjunct to the main curriculum. Despite this, lessons learned from SCD are key to understanding the holistic patient-centred experience. It is an opportunity to combine advanced clinical knowledge with patient management, which all dental professionals should possess in order to fulfil our duty of care for all. The aim of this article is to explore the lack of exposure to SCD in undergraduates, and highlight the reasons behind the management of patients with additional needs being an essential part of the undergraduate curriculum and beyond. The article also explores the importance of SCD in treating patients in an increasingly diverse society, particularly for those with complications related to the recent COVID-19 pandemic.