Following up from my previous blog about the management of complex restorative work in patients who then do go on to develop dementia; I found myself asking how effective our community dental services are, and how well integrated they are with secondary dental care.

As a DCT in a hospital post, I have a lot of admin to deal with; most of this is writing letters back to GDPs, GMPs, patients etc, informing them of either treatment planned or completed. As a DF1 the only letters I would write were referrals on a proforma, with little strategy in place to follow up on the progress and outcome of these. This picture is by no means unique, speaking to colleagues in other parts of the country; the story is more or less the same. There is a clear lack of communication and I feel as GDPs we can do a lot more to bridge this gap.

I have no doubt that there are well integrated services provided by primary, secondary and general dental practices, but this is not consistent throughout the country.  From my experience and that of colleagues I have spoken to, our dental care services do not provide reliable joined up/integrated services. The question for me and lots of other young dentists is how do we as GDPs manage dementia patients in practice, where do we refer when we are unable to provide the treatment needed, and who takes responsibility for their on-going dental care?

Whilst I accept that there might be few patients who need to be treated within a secondary care setting for prolonged periods, a more integrated and well run dental service could support patients to stay out of hospital, and be cared for in the community. I know this is happening more and more now but it’s an issue I think a lot of young dentists are not well taught about and can sometimes struggle with when faced with this scenario.

Your views and comments are welcome.