Dentist - Struggling with Dental Care – Reasonable Adjustments Not Taken Seriously

Nashota

Hi all,

I have both physical and mental health conditions that make attending appointments difficult — especially dental ones. I’m classed as disabled under the Equality Act 2010, and I believe I should be entitled to reasonable adjustments, but I'm struggling to get anywhere with this.

In 2023, I had a couple of dental appointments where I specifically requested not to be leaned back too far in the chair, due to my health conditions. Despite this, the dentist ignored my requests. This triggered panic attacks and made my dental phobia significantly worse.

When I raised this with the practice manager, she responded with inaccurate information and then told me to speak to the dentist. But when I did, the dentist just said she’d talk to the practice manager — and nothing happened. I didn’t chase it up at the time, but I did mention it again in a recent email. Her response was that she “wasn’t in the appointment” (obviously!) — and when I asked her about writing a reasonable adjustments request, she told me to speak to a dentist instead. To my knowledge, it’s the practice manager’s responsibility to handle and record reasonable adjustments, so this response wasn’t helpful.

This whole experience has made me extremely reluctant to go back. The only thing helpful she’s said is that I’m allowed to switch to a different dentist within the practice.

I’m now at the point where I feel I need to write a reasonable adjustments letter, but I’m not sure what to include or how best to go about it. My dental health is deteriorating — my teeth are falling apart — and it’s getting urgent.

The adjustments I need are pretty simple:

• Not to be leaned too far back in the chair
• No drill use, as it causes extreme anxiety and panic
• Preference for extractions over fillings/crowns (especially after a crown recently fell off and revealed more decay)
• No molds/impressions, as they cause me to panic
• Concerns about sedation due to past sleep apnea and gas allergies — I also can't swallow tablets or capsules

I just want to be able to get dental care without added trauma and fear. Has anyone here successfully written a reasonable adjustments letter to a dental practice? Any advice or support would be really appreciated.

Thanks for reading.

Nashota

No one?

I'm really just wanting to know if it's the practice manager who should be addressing reasonable adjustments? She seems to try and shirk her responsibilities like she did when I complained a couple of years ago.

Chris75_

I don't even have a dentist to demand adjustments from! 🤔

Nashota

A lot of people don't at the moment, sadly. Finding a good one where I live appears to be a bit of a chore.

Albus_Scope

Hi @Nashota apologies for the lack of replies, most members come here in their free time, which can sometimes be after work, so replies may take a while.

This is a tricky one as reasonable adjustments do have to be reasonable for the dentist to still be able to address any dental issues you may have. It may be case of the practice manager not being able to find any ways to put all of these in place for you? But putting things in writing is a must here, as it will leave a paper trail, so I'd suggest writing an email to the practice and ask for the notes to be added to your file. Then maybe ask to see a different dentist who will hopefully read those notes before your appointment.

Nashota

When I mentioned sending her a letter for reasonable adjustments, she fobbed me off straight away and tried to dump it on a dentist, she didn't even ask any questions or anything else and doesn't know the extent of my disabilities or dental phobia! I've read it's meant to be the practice manager that deals with requests, so they can be noted down in your records for the dentist to see.

She was useless with the complaint that I made a couple of years ago as well! She passes the buck rather than properly looking into it herself.

I'll do that, because apparently by law (under the Equality Act 2010) they are supposed to put adjustments in place which I had tried previously and directly with a dentist who totally ignored my request not to be leaned back to far and in turn I had panic attacks, she did this on more than one occasions and has now unfortunately made my dental phobia worse, she also didn't give me a choice about the tooth she drilled down and put a crown on, less than 2 years later the crown has fallen off and the tooth is decayed, she should have pulled it out to begin with, she caused me a lot of stress for no reason (in my opinion) all because she thought she knew best and wouldn't listen to me or read written requests, hence me asking about sending a proper request to the practice manager.

Nashota

Just to add with regards to my tooth, it was already broken and such so I don't understand why she did it. She could have removed it and given me a partial denture, much easier than what she did, unless it's for the money, I don't know.

Albus_Scope

It's not specifically the practice manager who must make notes, it only states "the practice" must, so it sounds like they're definitely passing the buck on who has to do the data entry, which I get is totally unhelpful and infuriating for you!

Nashota

I see, the thing is as well, I already filled a questionnaire out with details of my difficulties, it literally asked about being leaned back in the chair and I also just remember that as well as writing notes and handing them to the dentist, I also wrote emails requesting the same and explaining my difficulties, but she still ignored them and the practice manager as I keep saying wasn't much use when I complained.

I'll send her the reasonable adjustment and if she doesn't like it, tough, I'm not going to start taking notes in to another dentist and waste appointment time. The only useful thing the practice manager did was let me switch to a different dentist and to one on the ground floor.

It's very infuriating as someone who struggle with mental health conditions, all I want is to be able to go and get my teeth sorted without someone causing me to have a panic attack.

Prior to this lot taking over the dentists actually listened, I had one who tricked me a bit but she didn't cause me any harm with it, she basically asked how many teeth I wanted removing as I had 4 that needed to go, I wanted one, she pulled the 4 in a very short space of time, I didn't even realise lol, I wish she was still there.

Nashota

I just type something out which seems to have gone poof when I tried to post it.. unless it appears when I post this.

Edit - nvm it appears x amount of minutes later lol.

Albus_Scope

Apologies @Nashota it would appear a word you mentioned triggered our keyword filter, so I had to get the comment out of jail before it would show up. 😆

Nashota

Lol, ok thank @Albus_Scope 😁

Nashota

Just to clarify before I do it @Albus_Scope I'm sending an email to the practice asking for reasonable adjustments/notes to be added to my records?

Should I take a note when I do have an appointment? Hopefully the next dentist will want to help me.

I feel like they should have already done this with me already making requests to the previous dentist via email as well as in person via notes.

Albus_Scope

Yes I'd suggest just emailing the practice. You don't need to address it to the manager, just to whom it may concern. Mentioning the Equality act 2010 as well. If you give them a list of the adjustments you feel you need, they can add notes, but it is worth noting they don't have to comply with all adjustments if they deem them unreasonable.

Nashota

That's fair, I don't want anything big, I just want the things I've said in my initial post, I want to be able to attend appointments and for the dentist to actually take notice of my needs.

I've actually asked the medical centre if GP's are able to refer to those community dentists because I'm wondering if they'd be better?

I'm also trying to find a different practice in general, one with dentists who have experience with people like myself.

Albus_Scope

Quite a few dentists specialise in people with advanced needs as they'd call them, so it's certainly worth asking around.

Otteline

It seems to me that some of the things you are asking for will be difficult for the dentist to implement. For instance if you need fillings how will the dentist do these without a drill. Maybe you see your GP and ask for a referral to a dental hospital where they might be able to help you. Not sure what a normal dentist can do. Perhaps you need to be treated under anaesthesia?

Unfortunately most dentists will do all they can before they extract a tooth, including crowns and root canal fillings. They want to save the tooth at any cost. I know several people who had root canal treatment and then the dentist went on to extract the tooth anyway,

Otteline

https://forum.scope.org.uk/discussion/comment/1064523#Comment_1064523

Unfortunately NHS dentists are very few and far between. It seems the only way to get one for sure is to go down the private route.

Nashota

There's literally no point in drilling mine as they are falling to bits from me grinding them and reflux sadly. Honestly, I'd prefer to have them extracted. I explained about a crown I had put on a tooth, it fell off the other day and the tooth underneath it is decayed, so they'll probably end up extracting that anyway.

I can't be sedated from what I can gather, I mentioned it in my OP and I'm also not able to travel too far either, HOWEVER I did contact a I think it's called a community dentist who provide sedation to ask if they can help somehow and I have also contacted the medical centre about it. I'm waiting to hear back.

Holly_Scope

I'm a grinder too @Nashota in my sleep. And a talker 🙈 Hope you're able to make some progress with the community dentist today 😊

Nashota

Hi @Holly_Scope it's a normal dentist that I'm with currently, I've done as Albus advised and have sent them a letter of reasonable adjustments but I've done it to the practice manager because although the practice is responsible for the adjustments in general, I feel she's the best person to go to as I cannot do it during appointments, it'd be time consuming and I'm just not very good when speaking to people. I hope she doesn't do her usual thing where she says speak to a dentist or I may have to make a complaint. Surly she can pass the email onto a dentist to make the adjustments because I don't know any of the ones downstairs and the one upstairs made my phobia worse, so I won't be going to see her again.

I'm waiting for the medical centre and the community dentist to get back to me still.

Yeah grinding is terrible because I didn't know I was doing it until I had an appointment for sleep apnoea, and it was the doctor there who pointed out that I likely grind my teeth which obviously explains the other issues like my jaw hurting, I believe I have an overbite now as well.