Quick access dental pathway for

vulnerable children – homeless/ Roma travelling and refugees

Mr Thayalan Kandiah – Paediatric Dental Consultant

Paediatric Dental Department, East Surrey Hospital

@sashnhs @KandiahThayalan

Aims

• To demonstrate the need for a care pathway for vulnerable children

• To demonstrate the need for a tailor made service

• To present our findings of vulnerable children who have been seen

so far

Learning outcomes

• Current state of Paediatric dentistry – locally and nationally

• Issues faced by vulnerable groups

• Benefits of a multi-agency care pathway

What is paediatric dentistry?

The specialty of paediatric dentistry is the practice, teaching of and

research in the comprehensive preventive and therapeutic oral care of

children from birth to adolescence

Dental issues

Healthy dentition

Dental decay

Consequence

So why do we save kids teeth?• Quality of life

• Growth and development

• Life long impact on dental health

• Burden of care

44, 047 children aged

0-19 were admitted to

hospital because of tooth

decay in 2017-18.

In the news

Local challenges

National challenges NHS Digital’s hospital admitted patient care activity, 2017-18 showed that:

• Over 26,000 children ages five to nine were admitted to hospital due to

tooth decay in 2017-2018

• More than double the number of five to nine year olds were admitted to

hospital for dental caries compared to tonsillitis in 2017-2018

• Tooth decay remains to be the number one reason that children aged five

to nine are admitted to hospital

• In total, 44, 047 children aged 0-19 were admitted to hospital because of tooth

decay in 2017-18.

• The number of hospital admissions for tooth decay for children ages five to

nine has increased for the second consecutive year.

• However, hospital admissions for tooth decay in other age groups have

decreased.

• Data reviewed in 2018 showed that almost one in three (31.5%) five to nine

year olds had not visited an NHS dentist in the past 12 months.

National challenges

Creation of a pathway

• Since December 2017, the paediatric team in East Surrey Hospital

have been referred 22 children

• These have been categorised into three groups;

– Roma travelling families

– Homeless children

– Refugees

Where are we now?

The age of referral ranged from one years old to 12 years old, with the

mean age being six and a half years old.

13 (59%) of the children were male, and the remaining nine (41% were

female).

Statistics so far…

Statistics continued…

17

5

0 5 10 15 20

Brushing once a day or less

Brushing twice a day

Oral hygiene as graded by a member of the dental team

Poor

Fair

Good

Oral hygiene habits

23%

9%

14%

45%

0%9%

Active monitoring

Local anaesthesia

Inhalation Sedation

General anaesthesia

Discharge

Other

Treatment outcomes

• Promote awareness of this pathway to increase the number of

referrals

• More children have since been referred to our team, and data is

being analysed

• Please contact our team if you have any queries

Next steps…

Thank you

Start by doing what is necessary, then do what is possible, and

eventually you will be doing what is impossible -

“.

.” Francisco de Assis

References

• NHS Digital’s Hospital Admitted Patient Care Activity,

2017-18 : https://digital.nhs.uk/data-and-

information/publications/statistical/hospital-admitted-

patient-care-activity/2017-18