NHS Update: Oral healthcare for autistic children

November’s ‘NHS Dentistry and Oral Health Update’ announced the publication of a new clinical standard to improve the oral health of autistic children and young people. Jason Wong, interim chief dental officer, also urged readers to engage with awareness days to improve public health.

Jason opened the bulletin by reminding readers of the importance of several annual national awareness campaigns - World Antimicrobial Awareness Week (WAAW, 18-24 November), the European Antibiotic Awareness Day and Mouth Cancer Action Month.

Of particular interest was his reflection on mouth cancer awareness. Jason explained the “potentially lifesaving” impact of the 45-second self-check for mouth cancer and urged dental professionals to highlight its benefits to patients and colleagues.

He also announced the publication of ‘Clinical standard: Oral healthcare for autistic children & young people and/or those with a learning disability in special educational settings’. The standard “supports the vision of universal access whereby everyone receives quality health services that meet their specific needs, enabling people to live a life without active disease, discomfort or embarrassment.” It is specifically designed to improve outcomes for “autistic children and young people (CYP), and those CYP with a learning disability”.

Antimicrobial resistance

The 2023 campaign for WAAW called for “cross-sectoral collaboration to preserve the effectiveness of antimicrobials.”

Jason stressed that to reduce antimicrobial resistance (AMR), healthcare professionals “must use antimicrobials prudently and appropriately”. He reminded readers to ensure “preventative measures” and good disposal practices are in place “to decrease the incidence of infection”.

Tools and resources concerning tackling AMR include:

‘Antimicrobial prescribing in dentistry good practice guidelines’
‘A self-audit tool for clinicians to review how their prescribing aligns with the guidelines’
‘The dental antimicrobial stewardship toolkit’
‘English surveillance programme for antimicrobial utilisation and resistance (ESPAUR)’ report

Mouth Cancer Action Month

The OCDO said it wants to “encourage as many people as possible to regularly check their mouth for the early warning signs of mouth cancer.”

Symptoms of mouth cancer include:

“Sore mouth ulcers that do not heal within several weeks
“Unexplained, persistent lumps in the mouth that do not go away
“Unexplained, persistent lumps in the lymph glands in the neck that do not go away”

The update advises staff to contact their local “oral medicine or oral and maxillofacial surgery specialist service for expert opinion” if they are ever “in doubt about a suspected diagnosis.

To help raise awareness, Jason encouraged practices to get involved with the Mouth Cancer Foundation’s annual Mouth Cancer 10km Awareness Walk in Hyde Park.

Helpful resources available include:

“An oral care guide for staff
“Referral assistance documents
“A patient handbook
“A cookbook for those with difficulty swallowing
“Support groups”

Clinical standard: Oral healthcare for autistic children and young people and/or those with a learning disability in special educational settings

Produced with input from specialist consultants, the OCDO’s new standard will “improve oral health and reduce the detrimental impacts of dental disease experienced by autistic children and young people and/or those with a learning disability in a residential special educational setting in England.”

The guidance builds upon the government’s “guide on oral care and people with learning disabilities.”

Care Quality Commission's statutory guidance on Regulation 18 states two specific points concerning staff training related to learning disabilities and autism:

“Registered providers must ensure that all staff receive training in how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role
“Staff must receive appropriate supervision in their role to ensure they demonstrate and maintain competence in understanding the needs of people with a learning disability and autistic people, including knowing how to support them in the best way”

The bulletin recommends The Oliver McGowan Mandatory Training on Learning Disability and Autism. It is the “government's preferred and recommended training for health and social care staff”.

BDIA 2024

On March 22 and 23, 2024, the OCDO will welcome professionals to the Chief Dental Officer’s zone. It will be hosting CPD sessions covering: