Special Care Dentistry

The special care team work closely with medical colleagues at Ninewells Hospital as well as hospitals across Scotland. We play an active part in assessing patients prior to transplant and cardiac surgery as well as in assessing patients about to undertake treatment for certain types of cancer, including leukaemia and myeloma. We deliver some treatments for patients with inherited bleeding disorders at Ninewells Hospital.

Dr Heffernan and Dr Martin are both very experienced in the management, planning and treatment of older people. Both are trained and qualified to assess incapacity and to issue Adults with Incapacity Certificates (Section 47 certificates), authorising dental treatment, where appropriate. However, we are currently unable to offer treatment on a domiciliary basis.

As Specialists in Special Care Dentistry, Dr Heffernan and Dr Martin are both experienced in the management of patients with either learning and/or physical disability. Since patients cannot be registered for ongoing dental care with Dundee Dental Hospital & School specialist teams, these patients are more regularly treated by our colleagues in special care in the Public Dental Service. We are, however, very happy to receive referrals for patients who have learning and/or physical disability, although we do not have access to certain disability aids, such as a wheelchair tipper.

Patients who have mental health problems, who are affected by, for example, substance misuse or who are affected by homelessness are all welcome to be referred if they require specialist treatment and/or advice. As with other groups of patients, we are not able to provide continuing care and patients will be discharged when treatment is completed.

Both Dr Heffernan and Dr Martin are trained sedation dentists. Both can provide intravenous (IV), oral and inhalation (RA) types of sedation. The department runs several sedation clinics a week within Dundee Dental Hospital & School. For patients with very complex medical histories/conditions, we have a joint Special Care and Anaesthetist session once every two weeks, which is also held within Dundee Dental Hospital. We are unable to offer advanced restorative treatment under any form of conscious sedation.

The Special Care Team have limited access to general anaesthetic lists; currently there is one session per month. In line with current guidelines, this is not able to be held at Dundee Dental Hospital and takes place at Ninewells Hospital only. We are unable to offer advanced restorative treatment under general anaesthetic.

This clinic uses evidence based behavioural management techniques to help adults and older children manage anxiety or other psychological difficulties that may be preventing them from receiving dental treatment. These techniques include helping the patient understand how their difficulties emerged and what factors might be maintaining their difficulties. Patients are taught a variety of behavioural strategies such as relaxation techniques and graded exposure, which they can use to help manage their anxiety.

We see adults and children who are unable to receive dental treatment as a result of general dental anxiety or a specific dental phobia, for example, needle phobia. Patients with more complex psychological difficulties may be referred on the understanding that the aim of the intervention is to help them manage difficulties they may have in relation to dentistry.

Patients should agree to a referral to the anxiety clinic and be motivated to use behavioural techniques to help them manage their dental anxiety. All patients will be assessed by a psychologist prior to commencing treatment on the Anxiety Clinic. Only basic restorative dental treatments are carried out on the Anxiety Clinic.

For patients who require the use of bariatric facilities, they should be referred to the Public Dental Service at Kings Cross Health & Community Care Centre (Dundee), Broxden Dental Centre (Perth) and Springfield Medical Centre (Arbroath).