Community and Special Care Dentistry

Special Care and Community Paediatric Dentistry in Sheffield is mostly provided by Community and Special Care Dental service [C&SCD] in primary care clinics. Staff from this service also provide in-reach clinics at CCDH for those patients with complex medical conditions who need to be seen in a hospital environment. Special Care and paediatric dentistry operate their own central referrals system and patients are then offered a clinic appointment at a location that best suits their needs.  

For people that meet the acceptance criteria, the consultant led service offers patients a full oral health assessment and subsequent treatment as appropriate with a range of dentists, specialist nurses and hygiene therapy staff. 

At the end of an episode of care patients may be referred back to their own dentist or another high street dentist under ‘flexible commissioning’ arrangements.  Some of these may require support from our specialist services occasionally on a ‘shared care’ basis.  

For those patients that can’t be managed in general practice, ongoing care within the service is available.  

The C&SCD service is not an emergency dental service and patients referred from a dentist will remain the responsibility of the referring practitioner until a clinical assessment has been carried out and the patient accepted for treatment. Patients referred by a non-dental health care professional, who has not been clinically assessed and accepted for care require signposting to NHS 111. 

Wheata Clinic   

Address - Wordsworth Avenue, Sheffield S5 9JH 

Number - 0114 3078306

Car parking is available. There is a car park at the front of the building.  Disabled access and parking are available.

 

 

 

 

 

 

 

Manor Clinic      

Address - 18 Ridgeway Road, Sheffield, S12 2ST 

Number - 0114 3078402 

 

There is no car park at this site. Parking spaces are available on nearby side roads off Ridgeway Road. 

Disabled parking and access are available at the back of the building by going down the slip road just after the clinic and before the shops.

Supertram - take the Blue Route (Halfway) or the Purple Route (Herdings Park) to Manor Top. The tram stop is across the road from the clinic. 

Limbrick Clinic  

Address - Limbrick Road, Sheffield, S6 2PE 

Number - 0114 3078740 

 

Car parking is available. There is a large car park at the far end of the building.  

Disabled access and parking are available.

 

Patients from the following categories are accepted:  

  • Adults and children with a moderate or severe learning difficulty 
  • Adults and children with moderate or severe physical and /or communication impairment 
  • Adults and children with neurodiversity that impact on the provision of dental care 
  • Adults with severe mental illness that prevents them accessing care from a high street dentist  
  • Children with other special needs affecting the provision of dental care, including those with severe anxiety or other behavioural management difficulty where treatment has already been attempted 
  • Patients who for medical reasons (including those with neurodegenerative disorders), cannot receive care in general dental practice but who do not require care in a hospital setting. Medically compromised patients will normally only be accepted for a single course of treatment and the referring practitioner expected to continue to provide preventive and routine care. 
  • Frail elderly people that cannot be managed in a general dental practice  
  • Adults that meet the entry criteria for Sheffield’s dental pain and anxiety pathway, and for whom an assessment of their dental anxiety has been completed  

Patients not meeting one of the above criteria will not be accepted.  

Please note that the Special Care salaried service does not provide a GA referral service for children or adults  

Patients requiring complex restorative care, orthodontics or oral surgery should be referred to specialists in these specialities, and not to special care dentistry.  

Referrals should be made using the Community and Special Care Dental Service Referral Form 

A supplementary form will need to be completed for adults with severe dental anxiety or dental phobia, people with mental health problems and people with a bariatric need (appendix 4).  

Pain & anxiety dental referral form

Mental Health supplement

All referrals should be sent to: sht-tr.centralreferrals@nhs.net  

Please note any referral made electronically must only be made from an NHS.net email account to ensure security of transmission of patient identifiable data. If an NHS.net email is not available contact the central referrals team at the above email address who will password protect documents. 

An initial appointment will be made for assessment and treatment planning, with treatment carried out at subsequent appointments. Assessment will be carried out by a senior clinician, but as the service is a training service, patients should be made aware that their treatment may not necessarily be done by the dentist who initially assessed them, and that some or all of their treatment may be carried out by a trainee under supervision. Some treatments e.g. sedation are only provided at specific locations, and patients may have to transfer clinics for specific treatments.  

Patients should only be referred where the learning difficulty severely impacts on their ability to accept dental care. Many of these patients who meet the Special Care service’s criteria need an accompanying carer or relative to enable them to access dental care. Please supply name and contact details of such carers when appropriate. A traffic light system – Hospital passport, is available for carers or relatives to complete prior to attendance indicating a patient’s specific care needs.

Patients with a severe mental illness that cannot be managed in a general dental practice. Some patients are under the care of a registered mental health practitioner (e.g. psychiatric team, community mental health nurse). Details of their current mental health practitioner should be given in the medical history. It is usual for the Special Care service to contact the mental health practitioner and obtain a mental health risk assessment prior to offering an appointment. To make a referral, a supplementary referral form needs to be completed and sent with the normal Charles Clifford Dental Service referral form.

This includes children with either a disability or behavioural problem that affects the provision of dental care. Children will normally be accepted for a single course of treatment but may be offered continuing care if difficulties are ongoing. Note that Community and Special Care Dentistry operates a similar policy to CCDH and will reject referrals of children who have a high caries incidence but are manageable.  

Patients with complex medical conditions requiring care in a hospital setting will be seen by special care dentists but should be referred through CCDS. The sort of conditions appropriate for such care include the major blood dyscrasias, severe cardiac disease, severe respiratory disease, patients undergoing radiotherapy or chemotherapy, patients requiring C1 esterase inhibitor, patients on intravenous bisphosphonates, patients who may require sedation and are ASA 3 or above, patients who have been positively diagnosed as latex allergic, and with AIDS (not HIV infection). Note that neither CCDS nor Community and Special Care Dentistry accepts referrals of patients with blood borne viruses who are generally healthy, unless they meet the referral criteria for another reason

Many patients struggle to cope with dental treatment within the general dental services due to dental anxiety or phobia. Most of these patients may be managed within general dental practice through acknowledging their concerns and affording the patient more time and patience. However, some patients experience anxiety/phobia to such a degree that they cannot be treated within general dental practice. A specialist service is available for adult patients with a severe dental anxiety/phobia who meet all of the following criteria:  

  • The patient is 16 years or over. 
  • The patient has expressed severe anxiety/phobia about routine dental treatment.  
  • The patient’s anxiety/phobia has prevented them from accepting routine dental treatment.  
  • The patient has scored 19 or above on the Modified Dental Anxiety Scale questionnaire.  
  • The referring dentist has attempted to provide dental treatment on at least three occasions.  
  • The referring dentist can provide evidence of what they have already tried to do to help the patient with their dental anxiety/phobia.  
  • The referring dentist can provide evidence of what dental treatment/prevention they have already provided for the patient.  
  • The patient has agreed to attend any appointments that are made or cancel them as early as possible.  
  • The patient is ready to have their dental anxiety/phobia addressed.  
  • The patient understands that they may be managed using a variety of techniques, which may include psychological therapies e.g. cognitive behavioural therapy (CBT).  
  • The patient is willing to be contacted by telephone.   
  • The referring dentist is willing to see the patient again following discharge from the specialist service.  

To refer a patient, complete the anxious/phobic adult dental patient referral form following the instructions on the form and return together with the C&SCD Services Referral Form. Please note that this is not an emergency dental service. If a patient needs IV sedation for a ‘one off unpleasant dental procedure’ e.g. surgical extraction of wisdom teeth or a biopsy but is not usually anxious/phobic about routine dental treatment, please refer them directly to the oral surgery department at Charles Clifford Dental Services using the Charles Clifford Dental Services Referral Form. 

Patients referred for domiciliary care will be assessed at home. However, if it is found that they can travel to a dental clinic independently, and do not meet any of our other acceptance criteria, they will be discharged back to referrers at that point without any treatment being undertaken. Patients who cannot access your surgery solely because of physical barriers should be referred to another general dental practitioner with appropriate access. While the Special Care service has the facilities to provide comprehensive care at home it is often more appropriate to bring the patient into the dental clinic using appropriate transport. Note: for patients living in care homes, many care homes in Sheffield are in the ‘Residential Oral Care in Sheffield’ (ROCS) scheme and the home has a visiting dentist. Such patients should be seen by the ROCS dentist prior to referral to the salaried service.  

The Special Care service clinics has a clinic equipped with dental equipment/facilities to treat patients who are over 22 stones. The eligibility criteria will be patients with a body mass index over 40. For people with a BMI between 30-40 there should be an additional health need, with the additional health need being the primary reason of the referral. To make a referral, a supplementary referral form needs to be completed and sent together with the Community Dental Services Referral Form.

All referrals should be sent to: sht-tr.centralreferrals@nhs.net

As noted above patients should neither be referred specifically for sedation or GA nor promised that they will be given sedation. CBT is normally the method of choice for managing patients with a severe dental anxiety/ dental phobia. Sedation is only offered when alternative treatments have been tried and considered and failed. The salaried service does have an adult special care GA list at the Royal Hallamshire Hospital, but patients are only accepted onto this list as a last resort after all other options have been explored. It is very rare for a fit and well dental phobic adult to meet the criteria and be referred onto this list. Both inhalation and intravenous sedation are available. The Community service neither provides nor encourages oral administration of sedative agents for dental care, as using this route it is not possible to accurately titrate the dose appropriately. For certain patients the service has limited availability of hypnosis or acupuncture, which may be appropriate alternatives. When treating patients under sedation or GA the range of treatment offered is limited. Specifically complex restorative care is not available and teeth that might have been restored if sedation or GA had not been required will be extracted. Patients are made aware of these limitations, and referrals should not be made for complex restorative care. 

This service is available at the following Hospitals: