Treating Young Offenders

As part of an exploration of dentistry in ‘unusual environments’, Eschmann hears from Nicola Blake, a Senior Dental Nurse at Community Dental Services (CDS-CIC). Nicola coordinates all special care across Bedfordshire and mobile dental unit services, including regular visits to a 12-bed young offenders unit, which accommodates young people aged between 12 and 18.

As part of CDS-CIC’s mission to deliver a high standard of care to patients with additional needs, the employee owned social enterprise works with a young offenders unit in Lincolnshire to provide full courses of treatment. 

“We have a contract with the Lincolnshire young offenders unit to hold a clinic once every other month,” says Nicola Blake, the Senior Dental Nurse responsible for the coordination of all visits to the unit. “In dental emergencies the unit does have access to a local high street dental practice but in the main we are the primary source of dental care. The reason for this is that the young people have to be accompanied by staff when in the community, so where possible the unit prefers to have treatments delivered in-house.”

To provide the necessary care safely and effectively, Nicola and an accompanying dentist use a mobile dental unit, which they park in a fully secured area within the grounds. “There’s an area where the young people are picked up and dropped off from court that we are able to use. For everyone involved, this is an ideal setting for the clinic as it provides a safe base during our visits, without the need for extra security.

“Each time we visit we provide a range of treatments and may see either just a few or all the young people that day, depending on if there are new intakes. Indeed, some of them only stay for a short time before being released so it is sometimes the case that we only see a patient once. Because of this we always carry out an examination and treatment all in the same visit.” But as Nicola explains, this is not the only challenge of treating young offenders.

“Naturally there is the possibility of challenging behaviour from the young people, though I’m happy to say that there have been no major problems with behaviour on board the mobile clinic so far. Still, as an extra precaution and to minimise this risk we ensure that instruments are out of reach at all times and carry out checks throughout the day to confirm that all tools are accounted for.

“In terms of infection control, we are yet to experience any real challenges as our mobile unit has a fully functioning decontamination area and we follow guidelines to the letter. The only slight difficulty we have is that the infection control area is in the surgery, but with an efficient dirty to clean workflow and effective use of space we are able to maintain high decontamination standards without impacting the patient.”

As with all the other services provided by CDS-CIC, the mobile dental unit is subject to stringent infection control guidelines. “Aboard the unit all instruments are cleaned and disinfected in the ultrasonic bath immediately after use, before being sterilised in the non-vacuum autoclave, bagged and recorded according to HTM 01-05 standards,” Nicola continues. “This helps to minimise the risk of cross infection and reduce the likelihood of incidents.

“Surfaces are also wiped down between each patient as well as at the beginning of the day during the set-up when we arrive at the young offenders unit. My other responsibilities include de-gassing the ultrasonic cleaner for five minutes in the morning and completing a test run of the autoclave to ensure ultimate decontamination compliance. Once a month, one of the CDS-CIC dental nurses will deep clean the entire unit including the walls and ceilings.”

As Nicola Blake has demonstrated here, while some dental services can be very different to the standard format of the high street dental practice, infection prevention and control is no less important. Thus, with the right steps and quality equipment, high standards of compliance can be achieved alongside the effective delivery of dental care to patients in need – whatever the dental setting.

For more information on the highly effective and affordable range of decontamination equipment and products from EschmannDirect, please visit www.eschmann.co.uk or call 01903 753322

 Nicola Blake graduated in 1995 with a National Certificate in Dental Nursing before joining CDS-CIC in 1996. She is a Senior Dental Nurse and employee director for the board.