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Bradford Children's Services Online Procedures

Protocol Regarding Dental Procedures for Children Looked After

SCOPE OF THIS CHAPTER

This protocol is new and was added to the procedures manual in May 2016. It explains the process for ensuring all Looked After Children (including those accessing short break provision and who are remanded) receive a dental check within 40 working days of becoming Looked After.

Contents

  1. Introduction
  2. Timing of Dental Checks
  3. Process

1. Introduction

For the purpose of this document the actions within the protocol are also applicable to children / young people who are Looked After and access short break provision i.e. those with complex health needs or disabilities and young people who are also YOT service users.

2. Timing of Dental Checks

Initial dental checks for Looked After children aged 6 months and above should be carried out within 20 working days of the Initial Health Assessment and no later than 40 working days from becoming Looked After. Subsequent dental checks should be 6 monthly thereafter.

The importance of dental attendance should not be underestimated given the existing poor level of dental health in Bradford generally as well as the complex histories of some our Looked After Children who have experienced chronic episodes of neglect.

3. Process

  1. When the child / young person becomes known to the LAC Health Team, the dental situation of the child is reviewed as part of their statutory Initial Health Assessment. This is the responsibility of the LAC Nurse;
  2. However it is good practice for the child's Social Worker to enquire with either child or the carer as to whether the child is registered with a family dentist. This information should be used to inform the Initial Health Assessment. This will establish:
    1. If the child is already registered with a family dentist;
    2. When their last appointment was with their family dentist;
    3. If the child is in the middle of a course of dental treatment, for instance awaiting a referral to the Orthodontist;
    4. If the child is in pain and requires an urgent dental response.
  3. It is expected that the carers will ensure that the child attends all future dental appointments; 
  4. It is also expected that carers will share information regarding dental appointment attended at the child's LAC Review. Furthermore the child's Independent Reviewing Officer is responsible for collating this information from parents / carers at the child's LAC Review;
  5. If a Looked After Child does not have a family dentist it is the responsibility of the child's parent / carers in the first instance to register the child with a local family dentist;
  6. If the parent / carer is unable to register the Looked After Child with a local family dentist the child's social worker should alert the LAC nurse. The LAC Nurse will refer the child to BDCFT's Salaried Dental Service.  It should be noted that there is a significant waiting list to access the Salaried Dental Service (on average 10 – 18 weeks) and a referral will not prioritise a Looked After Child;
  7. When referring to the Salaried Dental Service the LAC Nurse will ensure that children with additional complex needs or cardiac problems are highlighted to ensure a swifter response from the Salaried Dental Service;
  8. It is not the responsibility of the LAC Nurse to ensure that the child attends their dental appointment with either a family dentist or the Salaried Dental Service.  The child's Social Worker is best placed to encourage and support carers in making sure that children attend the dental appointments. Foster Carers and residential staff also have a responsibility to ensure that a child in their care maintains their health by attending planned appointments, including dental appointments;
  9. Repeated non attendances at family dentists or the Salaried Dental Service, where an appointment has been offered, is unacceptable. Failure to attend dental appointments will be brought to the attention of the Foster Carer, Residential Manager, the Child' Social Worker and the Independent Reviewing Officer (IRO) by the LAC health team;
  10. For young people for whom dental health is not a priority and for those children with specific fears or phobias the LAC Health Team will support and liaise with the Salaried Dental Service or the child's own dentist in order to improve the child's dental experience and outcome;
  11. Whether a child attends their dental appointment or not the LAC Nurses will ensure, at each Health Assessment, that the child's record on SystemOne (Health database) is updated.  This will mean that non attendances are recorded in the child's health plan as well as the dates that a child last attended their dental appointment. The LAC Health admin team forward this information on a case by case basis to the allocated Social worker, who then is responsible for uploading this information to the child's case file.