Caring for patients with additional needs

Hearing impairment and access to dental care

When accessing dental care, it’s crucial for deaf people to receive the same level of care as hearing people.[iii] The Equality Act 2010 makes it a requirement that reasonable adjustments are made to make sure that everyone has equal access to dental care. This means that, in any situation where difficulties present, appropriate changes should be made to accommodate them.[iv] Communication is an obvious barrier here, as it can be difficult for those with hearing loss to understand what the dental team is saying. As such, it’s necessary for each member of the team to adopt alternative communication methods, make simple changes to policy, and use assistive devices which allow them to overcome these challenges.

This being said, it is important to assess each patient’s unique needs, to ensure that the practice is able to offer them the level of care they require. For example, 400,000 people in the UK rely on lipreading to communicate. Generally, they have lost their hearing with age, so it’s important to speak face to face, and without any face coverings to help ensure that you’re understood. Some deaf patients may have hearing aids, and might find it helpful to lessen background noise while having a conversation to allow them to hear their dentist more clearly. This might mean turning off drills and radios, for example.[v]

Many people, particularly those who were deaf from birth, use British Sign Language (BSL). If you do not already know BSL, it can be helpful to have a translator present during appointments, and make use of diagrams and information leaflets to ensure patients receive all of the information they need.[vi] The BSL GCSE is due to be introduced in September 2025, open to any student of any age, meaning that individuals can learn the language either at school, college, or as a private candidate.[vii] This is a great opportunity for many hearing people to learn a new skill which allows them to more easily understand and be understood by deaf people. Accommodating the needs of each unique patient can help to ensure that they have a pleasant experience in the practice, and that they are able to more easily understand their own oral healthcare.

Oral health in deaf patients

Research suggests that patients with additional needs, including deafness, are at a greater risk for developing oral health problems, even as children.[viii] Generally, those with impaired hearing have poorer oral hygiene and, in turn, an increased likelihood of gingival disease and caries.[ix] Further to this, research suggests that there is a higher incidence of bruxism in people who are deaf, which is thought to be a sensory response.[x] As such, it’s important for clinicians to focus on preventative care, with plans designed to reduce the risk of oral diseases and improve oral hygiene,[xi] the effects of poor oral hygiene reversed through visual oral hygiene education methods.[xii]

In order to most effectively teach deaf patients about their oral health and hygiene, it can be helpful to provide demonstrations of proper toothbrushing and interdental cleaning, as well as supply them with step by step written instructions or diagrams to ensure they are able to understand each detail.

Tailoring care for each patient

Each patients’ situation is unique, so it’s important to tailor the care you provide and methods you use to ensure they receive the highest standard of care. This might mean working together with the patient to find any areas of oral hygiene they’re struggling with, and making appropriate recommendations. For patients who are struggling to remove plaque, it may be useful to recommend an additional tool, such as a mouth rinse, to help remove bacteria.

Curaprox offers a range of Perio plus oral rinses, which makes it simple to deliver effective antibacterial ingredients to patients who need an extra boost. Depending on your patients’ needs, options include the Forte, Regenerate, and Balance oral rinses, allowing clinicians to easily tailor their recommendations to each individual. This is a great way to provide patients with the benefits of chlorhexidine and Citrox^® – which is naturally extracted from bitter oranges – for long-lasting antibacterial effects.

In order to ensure every patient has access to the care they need, it’s important to tailor oral hygiene advice to each individual, and communicate effectively using a method that they can understand. To ensure a positive patient experience, and to offer the highest standards of care, making reasonable changes in the practice to accommodate everybody is essential.

For more information, please visit www.curaprox.co.uk

[i] https://rnid.org.uk/get-involved/research-and-policy/facts-and-figures/prevalence-of-deafness-and-hearing-loss/

[ii] https://rnid.org.uk/get-involved/research-and-policy/facts-and-figures/prevalence-of-deafness-and-hearing-loss/

[iii] https://www.dental-nursing.co.uk/features/can-your-patients-hear-you

[iv] https://www.ndcs.org.uk/information-and-support/professionals/activities/resources/law/

[v] https://www.dental-nursing.co.uk/features/can-your-patients-hear-you

[vi] https://www.dental-nursing.co.uk/features/can-your-patients-hear-you

[vii] https://educationhub.blog.gov.uk/2023/12/21/british-sign-language-gcse-everything-you-need-to-know/

[viii] Goud V, Gupta R, Babu A M S, Das D, Kulkarni G, Swathi K. Oral health status and treatment needs among deaf, mute and visually impaired children of Gulbarga district – A population based cross sectional study. J Family Med Prim Care. 2021 Oct;10(10):3664-3669. doi: 10.4103/jfmpc.jfmpc_291_21. Epub 2021 Nov 5. PMID: 34934663; PMCID: PMC8653483.

[ix] Goud V, Gupta R, Babu A M S, Das D, Kulkarni G, Swathi K. Oral health status and treatment needs among deaf, mute and visually impaired children of Gulbarga district – A population based cross sectional study. J Family Med Prim Care. 2021 Oct;10(10):3664-3669. doi: 10.4103/jfmpc.jfmpc_291_21. Epub 2021 Nov 5. PMID: 34934663; PMCID: PMC8653483.

[x] Ahmed, T., Bradley, N. & Fenesan, S. Dental management of patients with sensory impairments. Br Dent J 233, 627–633 (2022). https://doi.org/10.1038/s41415-022-5085-x

[xi] Goud V, Gupta R, Babu A M S, Das D, Kulkarni G, Swathi K. Oral health status and treatment needs among deaf, mute and visually impaired children of Gulbarga district – A population based cross sectional study. J Family Med Prim Care. 2021 Oct;10(10):3664-3669. doi: 10.4103/jfmpc.jfmpc_291_21. Epub 2021 Nov 5. PMID: 34934663; PMCID: PMC8653483.

[xii] Camposa, Valeria, Ricardo Cartes-Velásquezb, and Michael McKeec. “Oral health and dental care in deaf and hard of hearing population: a scoping review.” Oral Health Prev Dent 18.1 (2020): 417-26.