Children with additional needs face barriers to dental care in Hertfordshire
Our latest report Smiles of the Future: Parent and Carer Perspectives on Children's Oral Health shows 4 in 5 Hertfordshire children visit a dental practice and most are positive about their experiences. However, some have been forced to use private dentists, or not go at all, because they can’t find a NHS dentist accepting new patients or face long waiting lists.
In total, 853 parents and carers shared their views about accessing NHS dental care and their children’s oral health.
Why did we do this work?
The purpose of this research was to hear from local parents and carers about their views and experiences of dental care for their children. We wanted to find out about:
- Potential barriers to taking child(ren) to the dentist
- Good practice and suggested improvement for dentists
- What information, advice and guidance would best support parents and carers to care for their child(ren)’s oral health
What did people tell us?
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4 in 5 children visit a dental practice.
The majority of children go to the dentist and most have good experiences. However, 9% do not attend at all and 12% receive private care because they can’t find a NHS dentist, or are on long waiting lists.
“It’s taken me 3 years to find a dental practice that accepts NHS children and doesn’t have a 5 year plus waiting list.”
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More than 1 in 3 parents and carers experienced barriers in accessing dental care for their children.
These included time constraints, financial challenges, limited appointment availability and the general environment of dental practices.
“When they stopped taking NHS clients it [became] difficult. [My] children’s teeth are so damaged now because the dentists are all asking for payment and… asking that we subscribe and pay monthly.”
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Most carers and parents of children with additional needs (30% of our respondents) didn’t receive the reasonable adjustments or accommodations they required.
They said the provision of specialist dental care needed to be improved and practices should have a better understanding of treating children with additional needs.
“Dentists can be great with SEND kids but can also be very off-putting. You have to find the right people (and hope your kid hasn’t been traumatised before then)!”
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Most NHS dental practices were kind, caring and understanding.
Many examples of good practice across the County. Areas for improvement included better communication, continuity of care and making dental practices more child-friendly.
“Training for staff on working with children… empathy and understanding, general kindness should be part of training, with regular refreshers/reminders.”
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4 out of 5 parents and carers want more oral health support to be provided by schools and more than a third were stressed or worried about their children’s oral health.
“Age-appropriate visuals and literature [showing the] consequences of not brushing teeth regularly and poor diet, and how this can affect their teeth.”
- Over 40% said rising costs had affected their ability to purchase healthy foods and this was having a negative impact on their children’s oral health.
What happens next?
Our findings have highlighted various ways in which children’s oral health can be improved and we have made the following recommendations to the local NHS, Hertfordshire County Council and dental practices.
Local NHS:
- Improve availability of NHS dental practices for children to ensure equal access.
- Ensure the NHS website is up to date in listing dental practices accepting children.
- Reduce waiting lists for appointments/acceptance onto NHS dental practice patient lists and specialist dental care waiting lists for children with additional needs.
- Create a range of communication resources for parents, carers and children providing education and information in age-appropriate formats.
Dental practices:
- Increase the availability of appointments for children outside typical school/working hours, including evenings and weekends.
- Make dental practices more child-friendly by encouraging parents and families to bring comfort and entertainment items (with advice on precautionary measures and infection control).
- Deliver training on how to support children and young people with additional needs or anxiety and how to implement reasonable adjustments and accommodations.
- Ensure people with physical disabilities can access practices.
- Ensure, where possible, children see the same dentist at each appointment to enable consistency. This is particularly important for nervous/anxious children.
- Interact directly with parents, carers and children and young people, telling them what they are doing during appointments and enabling enough time for questions or concerns to be answered.
- Educate parents, carers and children during appointments about preventative care to support them to take care of their oral hygiene.
We have received assurance that Hertfordshire County Council will work to support the effective implementation of supervised toothbrushing in schools.
“Improving children’s oral health remains a priority and we are committed to ensuring every child has the best possible start in life. We welcome the collaborative approach between the NHS and the local authority Public Health teams; working alongside Healthwatch, to implement initiatives that strengthen early access to dental care and reduce inequalities. This includes the introduction of a Child‑Focussed Dental Practice pilot, designed to support children in accessing dental services early and in the most appropriate way. By working together, we can help prevent avoidable dental disease, support families more effectively, and improve long‑term health outcomes for children across our population.”
Avni Shah - Director of Primary Care Transformation, Hertfordshire and West Essex ICB
If you are finding it difficult to access dental care, our article Struggling to find a dentist? offers advice and links to help you get the care you need.
The best way to find dental practices in your area is to use the NHS Find a dentist search engine.
When you type your postcode in, it will show you a list of all the practices in a 10-mile radius of that postcode. Under each practice name it will display:
- whether they are accepting new adults
- whether they are accepting new children, and,
- whether they are accepting new adults eligible for free dental care (e.g., on a low income, pregnant, etc).
Downloads
Download to read the full report.
