Dentistry at Home
David Gibson, Marketing Manager of Eschmann, speaks to a Community Dentist about providing home visits for patients.
We often forget that there are people who may not be able to visit dental practices for medical reasons. Whether these individuals are elderly, have disabilities or are mentally unable to leave their homes, these people still require dental care.
But how can dentists perform dentistry in a patient’s home? We spoke to a Community Dentist who covers the West Kent area about her daily schedules and how she overcomes the unique challenges that treating patients in their homes can bring…
A day in the life
“A normal schedule for me on a home visit day is to get up early, meet up with my dental nurse and assess the patient list so that we can decide which equipment we need for the coming day. I do home visits once a week, and during this time we see multiple patients within a certain area so that we can effectively treat as many people as possible. This means that we often see how many patients live within a short distance of one another and schedule our appointments with them accordingly – this is co-ordinated by my dental nurse
“We have a special car dedicated to home visits, and this needs to hold a significant amount of boxes and equipment as we provide a pretty comprehensive range of services for bedbound individuals. We can perform check ups (minus x-rays), simple fillings and simple extractions (if teeth are already loose) and we also provide patients with dentures, meaning that we have to have impression materials available as well as everything else we need to perform other treatments at hand and easily portable.
“As we treat such a wide range of patients we need to be adaptable and ready to provide whatever services they require. People may be bedbound as they are very elderly and cannot walk, or perhaps they may have agoraphobia and feel that they cannot leave their homes. In these situations it’s important to understand the troubles these individuals are faced with and react accordingly.
“Due to limitations, home visits should really only be a last resort, so we try to encourage people as much as possible to visit practices. For example, say a wheelchair user has been refused access to a practice before, we can direct them to a new practice with the appropriate facilities to be able to treat them.”
A challenging setting
As you can imagine, providing dentistry within a patient’s home can offer a unique set of hurdles that need to be overcome.
“I think one of the biggest challenges of what I do is the lack of equipment. As we have no x-rays and no suction, it can be difficult to properly diagnose problems and perform treatments. We also have to do what I call “dental gymnastics” – I’ve had to get into some pretty bizarre positions because there is no dental chair - so that can be quite the challenge!
“One of the other interesting obstacles is finding people’s houses in the first place. A patient may live on the 4th floor of a high street block of apartments with no parking, so access can be tough. Also, as some of these patients can’t leave their beds, there’s no one to let you know if you have found the right place when you get there!”
“Overall, though, I think one of the biggest challenges of my role is not being able to perform a treatment for a patient because of these limitations. This can make people very upset, especially as they will then have to call an ambulance to transfer them to a dental practice for the treatment they need.
“The key to overcoming these challenges is patience and proper planning. We can only do so much so it’s important to help patients realise this while helping them as much as possible.”
Keeping things clean
In dentistry we are used to sterile practice environments where we can contain infection easily. However, due to the on-the-road nature of home visits it’s not possible to use equipment such as autoclaves when it comes to decontamination.
“We follow the same guidelines as you would in a traditional dental practice setting. However, when it comes to infection control we have to do things a little differently. We use a lot of single use instruments, and we bring along our own waste bin and sharps bin – we have to be very careful to not leave anything behind. Items that need to be sterilised are sent out to a sterilisation facility.”
A better connection
Of course, community dentistry does come with its benefits too:
“One of the things I love most about my job is that it is so much easier to form an emotional bond with the patients we see. As we are in their home they feel a lot more at ease, and we can talk about things like their family and pets as these parts of their lives are all around us as we work. It also helps us with explaining oral health, as patients can ask us to look at their toothbrushes and other oral care products or show us how they brush and floss so that we can give them advice that’s really tailored to them.”
Helping those in need
In the end, it’s easy to see that community dentistry is a necessary and often unsung part of modern day dentistry. Although home visits do have their limitations, by performing this service community dentists are helping hundreds of people who would otherwise suffer. Challenges are there to overcome, and by doing so community dentists are helping to ensure that everybody has access to dental care when they need it, even those who are too vulnerable to leave their homes.
For more information on the highly effective and affordable range of decontamination equipment and products from Eschmann, please visit www.eschmann.co.uk or call 01903 753322