Table 2 System changes to minimise barriers to dental care in older people in inner-city area characterised by social deprivation
| Â | Organisational action- to minimise dental care | ||
|---|---|---|---|
Barriers to Dental Care | Dental teams | Primary Care Trusts | Department of Health |
Cost of Dental Treatment | Provide clear information on dental charges to prospective and current patients Ensure patients receive costed treatment options, sensitive discussions in relation to dental treatment and charges and the opportunity to agree course of treatment appropriate to circumstances. this includes the time period over when the care is provided. | Reduction on cost of treatment for older people Free dental check-ups for older people Provide specific information for older people on dental charges Commission free oral screening at day centres | Provide greater financial support for dental treatment in older people (free dental check-ups and/or free dental care or subsidised care) Ensure clear public information on costs and exemptions |
Fear of Dental Treatment | Take time to explain the treatment and put the patient at ease Keep the surgery environment friendly and welcoming Address stressors such as the noise of dental drills through provision of ear plugs or silent drills Positive image of dentistry | Request that postgraduate deaneries consider 'care for the older person' as an important area for continuing professional education | Support training on caring for oral health in older people, including the management of dental anxiety and phobia |
Accessibility of Dental Services | Facilitate the timing of the appointments to minimise indirect costs Ensure older people have appropriate physical access to dental care (e.g. disabled access) Employ dentists to travel around community centres providing outreach services | Proactively commissioning of dental services for older people, both routine and domiciliary care based on need Ensuring care pathways to dental care in general, including domiciliary services | Monitor uptake of NHS dental care by older people and ensure that access to NHS is appropriate |
Availability of Dental Services | Provide information about the practice and make it available at key locations in the local community – i.e. GP Surgeries, libraries, etc | Commission sufficient care for older people Provide information for older people on local dental services Provide information in GP surgeries and Health Centres on dental services serving older people | Ensure availability of appropriate care Raising awareness of older people's oral health needs across health and social care. |
Characteristics of the Dentist | Recognise that polite and friendly approach is valued by older people Minimise waiting times Recognise and manage fears relating to past dental care Taking time to talk to patients Provide an atmosphere of unhurried treatments Continue to Provide NHS dental care for older people | Request that postgraduate deaneries consider 'care for the older person' as an important area for continuing professional development | Developing the concept of dental practitioners with a special interest in providing care for older people |