Specialist dental care for adults with complex needs

Communication

• We can help with Interpreter services, including British Sign Language (BSL).
• We offer help for patients who cannot give consent or whose capacity to consent changes.

Anxiety and behaviour

• Step-by-step calming techniques and talking therapies like cognitive behavioural therapy (CBT).
• Treatment with sedation for anxious or gagging patients.
• Treatment under general anaesthetic for patients who cannot cope otherwise.
• Trained staff who can safely support patients needing clinical holding.

Access

• Step-free access, ramps, and lifts.
• Specialist wheelchair tipper, hoists, and transfer equipment.
• NHS patient transport for clinic visits if needed.

• Our receptionist will welcome you and check you in.
• You will see the dentist and dental nurse.
• The dentist will look in your mouth, ask questions and may take x-rays, including a special wide view x-ray (OPG).
• We will agree on a treatment plan and explain how we can support your needs.
• Some treatments may be provided by a dental therapist.

• If you can return to a normal dentist, we will help you to do so.
• If you meet our criteria for long-term specialist care, we will keep seeing you.

If you need to pay for treatment, see information about dental treatment charges.

For young people (teenagers):

If you don’t really like going to the dentist, that’s okay, lots of people feel the same way. This guide has fun and easy tips made by other young people to help you feel more confident.

You’ll learn how to:

• Understand what happens at the dentist
• Make a simple plan to help you feel calm
• Get ready for your visit with helpful ideas

With this guide, you can feel happier and more ready to go to your dental appointments! 

For all other adults: 

SilverCloud gives simple online tools to manage stress, anxiety and low mood. It helps you feel better by helping you think in a more positive way.

You just need the internet and sound on a computer, tablet, or phone. You can use the programme anytime and anywhere that suits you.

It includes fun things like videos, games, quizzes, audio guides and your own online journal to write in.

Visit the Talking Therapies website to access Silver Cloud.

NHS Herefordshire and Worcestershire Talking Therapies:

If you're over 16 and registered with a GP in Herefordshire or Worcestershire, you can refer yourself to NHS Herefordshire and Worcestershire Talking Therapies.

NHS Talking Therapies gives free, confidential help for stress, anxiety, and depression. Support might include counselling and self-help.

What is inhalation sedation?

Inhalation sedation, also called “happy air,” helps you feel calm and relaxed during dental treatment. You wear a soft rubber mask over your nose and breathe in a special mix of gases (nitrous oxide and oxygen). This helps you feel sleepy, warm, and a little tingly, but you stay awake and can still move and talk.

Why is it helpful?

• It’s a safe way to help you feel less nervous.
• It makes treatment easier and more comfortable.
• You will feel better quickly after the treatment is finished.

Are there any risks?

Most people feel fine, but sometimes, if the treatment takes a long time, you might:

• Feel too sleepy.
• Feel sick or be sick.
• Get a headache or feel dizzy.
• Take a bit longer to feel back to normal again.

Before your visit

• You can eat and drink as normal, but have something light and not just before your appointment.
• Take any usual medicine unless your dentist tells you otherwise.
• You can bring an adult with you, but you don’t have to. Please don’t bring any children.
• If you have a cold or find it hard to breathe through your nose, call us before your visit.
• Tell the dentist about any health problems or medicines you take.
• Let the dentist know if you might be pregnant or are breastfeeding.

During your visit

• Arrive on time. Please don’t bring children.
• The dentist will explain everything and answer any of your questions.
• Tell the dentist if anything has changed with your health.
• An adult can stay with you during treatment if it’s safe.
• The dentist will place the mask on your nose and start the sedation. Once you feel relaxed, they may use a numbing gel and then give you an injection if needed, which should not hurt.

After your visit

• You may need to stay for a short time until you feel fully better.
• Wait until you feel ready before driving, riding a bike, or using any machines.

This resource is designed to provide you with an overview, your dentist will discuss this in further details. Please ask your dentist to explain anything you do not understand.

What is intravenous sedation?

You will get a small injection in your hand or arm. This will help you feel calm and relaxed during your dental treatment. You won’t be asleep, but you might feel like you were afterwards. You’ll still need a numbing injection to stop the tooth from hurting during treatment.    

Why is it helpful?

• You’ll feel less nervous.
• You might not remember much about the treatment.
• It helps stop you from gagging.
• It works quickly and you’ll feel better soon after.

Are there any risks?

Most people are fine, but sometimes you might:

• Feel too sleepy.
• Feel sick or dizzy.
• Have a headache.
• Forget things for a short time.
• Get a small bruise where the injection went in.

Before your visit

• Eat light meals and drinks (no alcohol) before your appointment.
• Take your usual medicine unless your dentist says otherwise.
• Wear comfy clothes and shoes.
• Don’t wear nail polish, fake nails, or lipstick.
• Don’t use any drugs before or after your treatment.

During the visit

• Come on time with an adult who will take you home. Please don’t bring any young children with you.
• The dentist will explain everything and answer any of your questions.
• Tell the dentist if your health has changed recently.
• Your adult can stay with you if it’s safe.
• The dentist will give you the sedation and then numb the area before starting treatment.

After the treatment

• You’ll stay for a little while until the team says that you’re ready to go home.
• Go home by car or taxi with your adult, don’t use buses or trains.
• Rest for the day and eat light meals.
• Take your usual medicine unless told otherwise.
• Don’t drive, ride a bike, or use any machines for 24 hours.
• Don’t drink alcohol or use drugs.
• Stay near your adult and don’t lock yourself in the bathroom.

This resource is designed to provide you with an overview, your dentist will discuss this in further details. Please ask your dentist to explain anything you do not understand.

A general anaesthetic will only be undertaken after consultation and any alternatives have been discussed with a dentist.

What is general anaesthesia?

General anaesthesia means you are given medicine that makes you go to sleep during your dental treatment. You won’t feel anything while you’re asleep. This is done in a hospital, not at the dentist’s clinic.          

Why is it helpful?

• You won’t be awake or feel anything during the treatment.
• It helps you have dental work done if you’re too nervous or if other types of sedation don’t work for you.

Are there any risks?

General anaesthesia is very safe, but sometimes you might:

• Feel sick afterwards.
• Have a sore throat or a small nosebleed.
• Have fewer choices for treatment (your dentist will explain this).

Before your visit

• You’ll be told when to stop eating and drinking before your treatment.
• Your dentist or doctor will let you know if you need to change when you take your usual medicine.
• Wear comfy clothes and shoes.
• Don’t wear nail polish, fake nails, or lipstick.
• Don’t use any drugs before or after your treatment.

On the day  

• You might wear a hospital gown.
• The anaesthetic team will help you go to sleep safely.
• The dental team will do the planned treatment.
• You might still get numbing medicine in your mouth to help when you wake up.

After your visit  

• The nurses will let you know when you're ready to go home.
• Go home with an adult in a car or taxi, don’t use buses or trains.
• Rest for the day and eat light meals.
• Take your usual medicine unless told otherwise.
• Don’t look after young children or others that day.
• Don’t lock yourself in the bathroom or toilet, stay where your adult can help you if needed. 

This resource is designed to provide you with an overview, your dentist will discuss this in further details. Please ask your dentist to explain anything you do not understand.

Dental Resources