Patient-support techniques for treating patients with learning disabilities

Mencap estimates that there are approximately 1.5 million people in the UK with a learning disability, affecting an estimated 2.16% of adults and 2.5% of children.¹ Individuals with learning disabilities will present with a reduction in intellectual ability and difficulties with learning and understanding new information, social tasks and completing activities of daily living, resulting in the need for additional support.² There are varying degrees of learning disabilities (LD), ranging from mild to severe/profound, which will affect the capabilities of an individual as well as their ability to communicate and understand social interaction (Table 1). Under the Equality Act (2010), organizations, including dental services, must make reasonable adjustments to ensure services are accessible for people with learning disabilities.³

Owing to difficulties with social interaction and communication, patients may require additional time to support understanding, along with adjustments in communication methods, such as using clear simple language and easy-to-read leaflets with pictures.⁴ The patient's capacity to consent for treatment may be affected, and capacity must be assessed according to the principles of the Mental Capacity Act.⁵ Adults with learning disabilities experience poorer oral health, including suboptimal oral hygiene, poor gingival health and a higher prevalence of dental caries and periodontitis.^6,7 They also have higher incidence of unmet dental needs.⁸ This cohort of patients can find it difficult to access dental services, and when they do, dentists report difficulties in providing care, with commonly cited reasons including behaviour management of the patient and inadequate training or experience.⁹