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Breaking down barriers to care: Learning Disability Awareness Week 2021

Blog Author Charlotte Waite

Blog Date 14/06/2021

​​This Learning Disability Week, we outline the steps you can take to provide a positive experience for all dental patients.




The NHS estimates there are around 1.5 million people in the UK with a learning disability. Unfortunately, barriers to care for such patients are many. COVID has exacerbated these access issues, particularly for those who experience higher levels of oral health inequalities.


Working in the community dental service, I see a lot of patients with learning disabilities, both children and adults, especially when their treatment needs are more complex. But the reality is that many of these patients receive their dental care from general dental practitioners.


At the same time, many dentists say they do not always feel that confident about treating patients with a learning disability and as a result are unsure how they can best support their patients.


This Learning Disability Awareness Week, we’re aiming to tackle this issue by suggesting some of the things all dentists can do to help improve their patients’ experience of a dental visit, including some new Makaton resources.


Start by making simple changes  

People with learning disabilities may have sensory sensitivities, so the prospect of visiting a dental surgery is fraught with strange sounds, odd smells, bright lights – all of which can be anxiety inducing.


By making a few simple changes, we can help to ensure that everyone has a positive experience. This will hopefully mean they are comfortable coming back to see us more regularly, and we can support our patients to maintain good oral health.




  • Offering the first or last appointment of the day, so the surgery is not as busy and there is less wait time, so anxiety levels are lowered
  • Clearly explaining and demonstrating each procedure before it happens, using simple, clear language.
  • Counting down procedures, e.g. “10 seconds then we are finished, 10..9..8, etc.”
  • Reducing the amount of medical equipment or ‘noise’ in the surgery if possible. 


Use Makaton as part of your dental practice

“By being aware of just a few key signs ... [you] can make a significant difference to patients’ overall experience.”

Makaton is a system of signs and symbols which you can use alongside spoken language to help you communicate with those who have learning disabilities. I encourage you to download this set of prompt cards with signs and symbols so you can use them in your surgery (create a login on the site and search for ‘Your dental appointment’ in the Library section).


We know that good communication is key to helping all of our patients but by going the extra mile and by using this resource, we can help to ensure that all our patients feel supported. By being aware of just a few key signs, and by having the symbols readily available, dentists and dental team members can make a significant difference to their patients’ overall experience. I’ve seen myself how Makaton can really help. 


The prompt cards also include a resource which patients can use to support brushing at home. We have also produced a film, showing what a visit to the dentist is like for an adult with a learning disability, and how good communication can make it a positive one.


Help break down barriers and misconceptions

Research has suggested that many dentists say they are not confident about interacting with patients with learning disabilities and a result, are unsure how they can best support people with a learning disability. 


The media and often TV programmes don’t always get representations of people with learning disabilities right, and this is not helpful. We need to break down these barriers and misconceptions. Mencap have a great explainer on the difference between a learning difficulty and a learning disability on their website.


The actor in the film we’ve made was actually a bit anxious about visiting the dentist himself. Gary was excited to play the role of patient but had some misgivings about meeting me and sitting in the dental chair. 


However, when we explained that I wasn’t going to be doing anything beyond having a look at his mouth, counting his teeth and talking about tooth brushing, that made him feel much more comfortable. I had the chance to try out some of my newly-learned Makaton signing and use of the symbols. 


So, one of the best outcomes of this film for me so far, was getting this feedback from Gary’s mum about his experience taking part in the film: “He really enjoyed it and it’s helped encourage him to go to the dentist and getting used to sitting on the proper chair.”


Don’t let these patients’ needs get lost  

We all face challenges – lack of time, intense pressures and stress, the bureaucracy and administration - and we all know that this can lead to communication sometimes being the thing that gets pushed to the back burner, as we rush to get through the day.


Ultimately, we all have a responsibility to ensure the experience for all of our patients is the best it can be, whatever field of practice we are working in.


Good communication can make such a difference to our patients’ experience of care. Let’s ensure this is the case for everyone including our patients with learning disabilities. Please try out some of these simple changes that can help to make a positive impact on oral health.


Charlotte Waite


Charlotte Waite
Chair, England Community Dental Services Committee