Are they really limitations or do we limit ourselves?

Road_198889661Debbie Ganguli questions whether we go the extra mile for vulnerable patients.

Although there are limitations of care for all, when you involve the vulnerable these greatly increase, as does the requirement for a robust set of principles and ethics to ensure that you are truly offering the best and most appropriate care for your patient, and with the appropriate consent in place.


While many of our ‘golden’ population are able to afford a full set of titanium supported gnashers, a vast number of our more vulnerable population are not, and for them the question arises, ‘Will we continue to be in a position to fund dental healthcare in the way we do now?’ Sadly, when it comes to health (dental or otherwise) there is still a great divide that in some cases is dependent on prosperity, but also affected by funding and a postcode lottery.

Competing wants

Often with vulnerable patients, you are dealing with other ‘interested’ parties, eg family members who may have to give consent but who will certainly have their own opinion on any treatments offered. These situations have to be handled with great care, empathy and understanding, and hopefully reaching a happy halfway point, giving our vulnerable patient the best and most appropriate care, maintaining their dignity and respect, without forcibly subjecting them to both the opinion of well wishing family members and clinicians.


This may appear rather obvious and in a sense it is. However, in our scramble to put labels on items and people, we can do half a job. When considering the access needs of a patient, a very simple way of ensuring that the dental experience for both the patient and staff involved is safe and successful is to carry out individual needs risk assessments.

The assessment is carried out from the moment the patient’s car enters the car park. The team and I make it a priority to work with both the patient and carers who are the best people to ascertain individual needs.


Good dentistry is all about good communication. When you are treating the vulnerable this can be greatly reduced. As health professionals we are generally good at communicating effectively with our patients – it is all about taking the time to find the best way of communicating, giving the patient autonomy and dignity, letting them make their decisions rather than taking the opportunity away from them.


One of the benefits of private practice is the increased time that you get to spend with patients. We have the time to risk assess the patient, discuss care with both patients and family members and really develop meaningful caring relationships. I do believe this can be achieved on the NHS at times if we use the team around us.

Treating the vulnerable wherever you do it requires time to do this properly and effectively. By utilising the skill mix of your team, things can be achieved without over-stretching the valuable time of the dentist. Besides it doesn’t happen every day, and it is just going the extra mile for a patient that could be yours for a lifetime of care.

If you have any specific questions for Debbie, you are more than welcome to send them to [email protected]

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