Gallagher J E, Fiske J
King's College London Dental Institute, London, UK.
Br Dent J. 2007 May 26;202(10):619-29. doi: 10.1038/bdj.2007.426.
As a profession we have a responsibility to ensure that the oral health needs of individuals and groups who have a physical, sensory, intellectual, medical, emotional or social impairment or disability are met. In the UK, over 200,000 adults have profound learning disabilities and/or complex medical conditions. Adults with a disability often have poorer oral health, poorer health outcomes and poorer access to services than the rest of the population. This paper examines the need for Special Care Dentistry based on a review of published literature, surveys and health policy, and suggests how services might be delivered in the future. Existing models of good practice reveal that established clinicians working in this field have a patient base of between 850 and 1,500 patients per year and work across primary care and hospital settings, liaising with colleagues in health, social services and the voluntary sector to ensure integrated health care planning. On this basis, a conservative estimate of 133 specialists is suggested for the future, working in networks with Dentists with Special Interests (DwSIs) and primary dental care practitioners. A skilled workforce that can address the wider needs of people requiring Special Care Dentistry should be formally recognised and developed within the UK to ensure that the needs of the most vulnerable sections of the community are addressed in future.
作为一个专业群体，我们有责任确保身体、感官、智力、医学、情感或社会方面存在损伤或残疾的个人及群体的口腔健康需求得到满足。在英国，超过20万成年人有严重的学习障碍和/或复杂的健康状况。与其他人群相比，残疾成年人的口腔健康状况往往更差，健康结果更糟，获得服务的机会也更少。本文基于对已发表文献、调查和卫生政策的综述，探讨了特殊护理牙科的必要性，并提出了未来服务的提供方式。现有的良好实践模式表明，在该领域工作的资深临床医生每年的患者基数为850至1500人，他们在初级保健和医院环境中工作，与卫生、社会服务和志愿部门的同事联络，以确保综合医疗保健规划。在此基础上，建议未来保守估计需要133名专家，他们与有特殊兴趣的牙医（DwSIs）和初级牙科保健从业者组成网络开展工作。在英国，应该正式认可并培养一支能够满足特殊护理牙科患者更广泛需求的技术精湛的劳动力队伍，以确保未来社区中最弱势群体的需求得到满足。
