Specialist dental care for adults with complex needs

This is the referral form for specialist dental care for adults with complex needs. Please read all the referral criteria before submitting a form.

Referral criteria

Referral criteria for specialist dental care for adults with complex needs:

  • Moderate/severe and profound multiple learning disabilities/behavioural problems.
  • Moderate/severe physical and/or communication impairment.
  • Moderate/severe chronic mental health conditions, including dementia, requiring capacity assessment and best interest decision making.
  • People with complex medical conditions/ intermediate or advanced stages of progressive disease.
  • Significant communication impairment, including non-verbal.
  • Requiring specialist equipment – such as a hoist or wheelchair recliner.
  • Other vulnerable groups: socially excluded people( e.g. homeless, migrants, asylum seekers, refugees, gypsies, travellers and sex workers), people with drug or alcohol addiction problems, people in secure units).

We regret that we are unable to accept referrals for:

  • Routine or emergency dental care for healthy, co-operative adults.
  • Patients who weigh over 30 stone and require clinic based dental care. These patients should be referred to Birmingham Dental Hospital.
  • Root canal treatment in permanent molars unless there is good medical indication for retention of the compromised tooth or need to avoid of extractions.
  • Any patient aged under 16 years.

Please complete this form as fully as possible. There is no back button and you won’t be able to return to it once you press submit.  

Patient acceptance criteria

Note: Questions marked by * are mandatory










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