Dental services in rural Ireland:-Potential for health service integration

Abstract

Introduction: Donegal is in the Northwest of Ireland,in which there are many rural communities. The public dental service provides a General anaesthetic service (G.A) for children and people with special needs,from all over the county. Frequently these patients have multiple health problems and have difficulty accessing them. Public transport is sparse(no railway links,private bus companies serve most rural areas, so accessing centralised health serevices can be a problem) Many have lived long term in institutions,or attend day care units and are cared for at home. They don`t have a “voice”, and it`s our duty to meet their needs and facilitate them to enjoy fulfilling and healthy lives. A recent audit of the service(November 2016-March 2017) showed that 115 patients were treated in our G.A service. 29 of these had special needs. They were referred from 13 different clinics throughout the county. Integration of services for people with special needs .We assess the patients at a location which is nearest to them,their local health cente,community hospital residential unit or at home .Liase with their medical G.P to see if they need blood tests to be taken at the same appointment. .Some patients have had treatment carried out by their ENT surgeon at time of the dental GA We want to work on and expand the opportunity to share our GA slots with other services. Conclusion: Dental service needs to be seen as part of total health care. And in particular we need to remove barriers to access for people with special needs. - Integration is when oral health works within primary care. In this case, patients perceive that they are receiving dental Services that are a routine part of their health care.Source: Collins et al. 2010 - While dental disease is itself a discrete health concern, like many other chronic diseases it has broader health impacts (Returning the mouth to the body, 2012 Grantmakers in Health) Our aim should be to prevent dental decay but as part of a “whole body “health service. In particular make it more accessible and integrated for those with special needs. “The true measure of any society can be found in how it treats its most vunerable members”, Mahatma Ghandi