Tees Dental Access Referral Pathway for Early Help, Children in Need, Children in need of protection and Children in our Care

The aim of this procedure is for all staff involved in this dental referral pathway to understand the process and appropriately refer any child requiring dental assessment or treatment.

1. Introduction

1.1 The Dental Access Referral Pathway aims to provide a process for professionals to refer children with a safeguarding need for dental assessment and / or dental care.

1.2 Referrals can be made for children by any health or social care professional.

2. Referral Process
The following flowchart details when and who to refer children requiring assessment and / or dental care:

2.1 Referrals can be made to the following:

  • Child’s own identified dental practice
  • Family chosen dental practice
  • “Named Referral“ dental practice
  • Tees Community Dental Service (CDS)

2.2.1 Referrals to identified or “own” or “chosen” dental practice are not guaranteed and dependant on the capacity of practices to accept new patients. Please note: many practices will not be taking on new patients. However, in certain circumstances, practices may be able to prioritise a referral request if it is stated the child has a safeguarding need.

2.2.2 The only guaranteed appointment will be to named referral practices on the Dental Access Referral list. Please note: availability of routine appointments for dental assessment will be subject to capacity and there might be a waiting time.

2.2.3 Referrals to named dental practices can be made by contacting the practices on the Dental Access Referral list by telephone. Please ask the practice for an appropriate email address to send them the completed written referral form.

3. Children with additional needs

3.1 Children whose needs cannot be managed in a general dental practice setting can be referred to the specialist Tees Community Dental Service.

This includes a child or young person:

  • with extensive oral disease,
  • whose oral health care is complicated by intellectual, medical, physical, social, psychological and/or emotional factors/disability,
  • with developmental disorders of the teeth and mouth,
  • who are either too anxious or too young to accept routine dental treatment, with diagnosed special educational needs,
  • who have sustained complex traumatic dental injuries.

3.2 Referrals to the CDS can be made by forwarding the referral form to the following email address: nth-tr.tcdsreferrals@nhs.net or via the online portal.

4. Roles and responsibilities

4.1 Referring Professionals should:

  • Please make a referral to a Dental Practice in your Local Authority area if possible.
  • Seek consent for the referral, and stress the importance of regular dental attendance.
  • Provide details of the person able to give legal consent for the child’s dental treatment. It is essential to advise legal guardians that they will need to be present for the initial dental appointment to give consent for treatment. If the legal guardian is not present at the dental appointment to give consent the child will not be seen (unless deemed clinically necessary for the best interest of the child).
  • Copy your referral to the child’s social worker (if appropriate).
  • Provide an email address of the child’s social worker to be contacted if the child is not brought to their dental appointment.
  • If your referral is URGENT please let the dental practice know when you contact them and include details, such as pain and any obvious signs of infection, in the written referral form.
  • Please specifically ask if the family can envisage any difficulties with dental attendance or whether their child/foster child has any additional needs. Document the response on the referral form.
  • Tees Valley Children in Care Team Nurses should follow-up any referrals made by their team.

4.2 Named Referral Dental Practice/ Tees CDS should:

  • Send the dental appointment to the legal guardian of the child.
  • If the child is not brought to the first dental appointment or discharged following two consecutive ‘Was Not Brought’ (WNB) appointments, the referring clinician/social worker will be informed (providing their details have been included on the referral form).

4.3 Social Care should:

  • The Social Worker (SW) or lead professional is responsible for informing dental practices of any change of address if a referral has been made.
  • The identified named SW will be contacted by the dental team to support dental attendance if the child is WNB.
  • If the child is discharged from the dental practice / Tees CDS due to two consecutive WNB appointments, it is requested the SW follows-up with the family as required.
  • SWs to maintain oversight of dental referral and any follow-up required.