How to improve the access ?

Referrals and self-referrals:

  • Special needs patients referred by: GDPs, dental therapists, oral health promoters, GPs, social services, residential homes, learning disability centers
  • Waiting list matter
  • The decision about: a) routine dental treatment, b) treatment under IV or RA sedation, c) GA sessions, d) domiciliary visits, e) mobile dental unit use




  • special communication skills, eg. Makaton sign language use
  • surgery located and first floor, wide doors
  • ability to get in on wheelchair or larger electric scooter
  • ‘sectioned’ doors, able to open widely in case of wheelchair bound user
 Additional measures:
  • Special assistance to stay comfortable
  • Bariatric dental chair with increased weight limit

Bariatric chair


Combined equipment: reclining platform and bariatric chair

reclining platform


Easy-to-access dental chair (Belmont, ‘break-knee chair’)




  • wheelchair recliner – up to 50 stones – limitations: take the time to allocate the wheelchair bound patient into it, patient cannot be reclined too much, not great for ‘short’ dentists as they may need to use additional platforms to reach bariatric chair, also posture problems:  dentist has to bend a lot
  • advantages of wheelchair platforms: no hoist need, no manual handling, safer than hoist, patient comfort, dignity, movable,
  • do not recline obese patients too much as airways can be compromised (lots of fatty tissues)
  • transfer device (hoist) – hoist is perceived to be an indignified tool, patients really dislike it! therefore a wheelchair platform is much more acceptable
  • cushions, head rests, blankets to support the head, limbs or body during treatment



  • patient’s comfort can be improved by adapted head rest, eg. lubmar support

head rest


  • if patient is wheelchair bound (cerebral palsy, multiple sclerosis) and uses special pads to hold him/her in order to stabilize position – do not attempt to transfer him/her into dental chair
  • special, customized (custom made) ‘full-body’ cushions highly useful and practical – problem – cross infection control issue and some of them may not have CE mark
  • rota cushion to assist the patient with poor mobility: hips problems, spine problems, legs impairment, hemiplegia
  • leg cushion to support lower part of the body

rota cushin

  • “break knee” dental chair



  • “booster seat” to suport young patients

seat booster

„banana boards” – to slide from one seat to the other


  • „turn table”, swivel mats – to allow a standing person to rotate without moving their feet

turn table

hoist2banana board








  • Hydrogel, semi-individual headrests; can be heated or cooled down, eg. patient suffering from neck pain, stiffness, neuralgia.



Bariatric scale to measure weight, better and simple option than asking the patient who may be quite upset and crossed with this question.

Sara Stedy equipment very useful for patients with hemiplegia, eg. after CVA or stroke.