Salford Community Dental Service
What services are offered?
In partnership with General Dental Practitioners, Hospital Dental Services, General Practitioners, Health Visitors, School Nurses, Primary Care Networks, GM Urgent Dental Care Service, Social services, we
- provide oral health assessment, prevention and treatment of children and adults with complex medical/ social/ psychological/ extra needs requiring special care dentistry input, including home visits
- provide shared care in partnership with general dental service practitioners where patients can receive part of their care in general dental service settings.
- provide treatment and onward referral where necessary for patients who require specialist input in secondary care set up.
- offer enhanced services requiring equipment and skills such as inhalation sedation or hoists.
- provide assessment, provision of treatment, provision of GA exodontia and referral where necessary.
- participate in dental epidemiology.
- enable the provision of training to post graduate dentists as agreed with Health Education England and NHS England
Which services are not offered?
Bariatric service (those patients weighing over 22 stone)
Orthodontic Exposures or complex surgical/ extraction procedures
Restorative procedures for primary teeth under conscious sedation/ GA
TMJ disorders and treatment
Complex Periodontal Treatment
Molar Endodontics Under Sedation
Surgical endodontics/ apicectomies.
Referrals are for children for whom:
- Local anaesthesia has been offered/ attempted but proved inadequate or unsuccessful.
- Local anaesthesia is contra-indicated (e.g. in the presence of sepsis despite drainage)
- Extractions in young or very nervous children who are experiencing pain from irreversible
pulpitis and require conscious sedation as an adjunct to local anaesthesia for extraction
- Where there is an established allergy to local anaesthesia.
Referrals for simple extractions under GA in children will be accepted if they comply with the following criteria:
- Children between the ages of 3 years and 16 years
- Weight between 5th and 95th percentile
- ASA 1 and 2 and are generally fit and well.
- Simple exodontias only in 2> quadrants with symptoms of irreversible pulpitis/ or other associated pathology.
Assessment for routine exodontia under GA is carried out at Pendleton Gateway (or satellite clinic if appropriate) and GA exodontia at Salford Royal Hospital
Parents / Carers have to be able to conform to pre and post-operative instructions which may include Covid testing and isolation period prior to procedure if required.
Referrals for inhalation sedation will be accepted if they comply with the following criteria.
- Any age.
- Dental treatment using LA should have been attempted in General Dental Practice if
appropriate. Treatment attempts must be documented on the referral.
- Restorations of permanent teeth only – NOT primary teeth
- Simple exodontias of primary & permanent teeth
- Simple endodontic treatment of anterior teeth
Assessment for treatment under conscious(inhalational) sedation is provided at Pendleton Gateway (or satellite clinic if appropriate*) and treatment performed by dentists/ therapists within the CDS clinics (Pendleton, Eccles, Walkden)
SPECIAL CARE DENTISTRY
Referrals are accepted for individuals who have a physical, sensory, intellectual, mental, medical emotional or social impairment or disability or, more often, a combination of these factors or that require specialist care that is unable to be managed by a general dental practitioner.
The acceptance criteria are based on the guide for commissioning dental specialities.
GA – SPECIAL CARE DENTISTRY
Comprehensive treatment under GA to secure dental health (Radiographs, extractions/restorations/ simple scaling) for adult Special Care patients that meet the criteria*
- Patients aged 16 years and over
- Suitable for day case surgery
- ASA 1 and ASA 2
- Patients will be assessed and if deemed suitable for day case surgery will be accepted
For housebound or bedridden patient who cannot attend any appointment outside the home and who would also meet the Special Care criteria cited above.
- Domiciliary care can be provided for all age groups that fit the criteria.
An initial triage assessment is offered if the patient meets the above criteria for domiciliary care prior to treatment provision.
- oral health assessment, prevention
- simple periodontal treatment and scaling
- simple restorations no advanced restorative work (crowns/ bridgework)
- simple extractions (this is usually provided in the clinical environment and ambulance
transport must be arranged)
- Assessment and provision of dentures/ relines/ copy dentures as appropriate
What are the main reasons for rejecting patients?
Inadequate social/medical/clinical details provided in the referral
Inappropriate referral of adult/child not meeting the criteria for treatment provision specified
Incorrectly completed forms – treatment request does not match charting request
Patients requiring routine check-ups and simple dentures who do not meet the criteria for access* will not be accepted for domiciliary care. Please note patients who can get out of the home to attend appointments for podiatry, hairdressing, GP or social events will not be accepted for domiciliary care.
Bariatric patients (over 22 stone) requiring dental treatment using a wheelchair recliner/ tipper and/or bariatric bench.
Children under 3 years for treatment under general anaesthesia.
Note for all referrers – please remember
Referrals accepted for AGP/ Non AGP treatment procedures under inhalation sedation and extractions under GA in line with the above acceptance criteria