Information
As part of the Oral Health Service (OHS), the Adult Dental Anxiety Management Service (ADAMS) provides behavioural, psychological and pharmacological approaches to managing dental anxiety / phobia for adults (16 years and over) resident within NHS Lothian.
The ADAMS accepts referred patients from their registered General Dental Practitioner (GDP) for a single course of treatment. Patients will be returned to their GDP when they are considered suitable for ongoing ‘continuing care’.
The ADAMS offers a range of treatment modalities:
- Behavioural management techniques
- Inhalation sedation
- Access to intravenous sedation (dentist / anaesthetist led depending on ASA classification)
- Access to general anaesthesia
Please note that patients should not be referred for a specific treatment modality. The ADAMS will assess and determine the treatment modality most suited for the patient.
Patients meeting our acceptance criteria are allocated to ADAMS clinics in date order. Where possible, the course of treatment will be carried out at the same clinic as the initial assessment. Please note that some treatment modalities are carried out in specific locations e.g. general anaesthetic and anaesthetist led intravenous sedation clinics are carried out at St John’s Hospital, Livingston.
Treatment is provided under General Dental Service (GDS) terms and conditions with strict adherence to the Statement of Dental Remuneration (SDR).
NHS fees apply to all unless the patient is entitled to free dental treatment
Who can refer:
The Adult Dental Anxiety Management Service (ADAMS) only accepts routine referrals from General Dental Practitioners.
Who to refer:
Registered patients requiring dental treatment whose dental anxiety / phobia necessitates behavioural or pharmacological management techniques beyond that provided in the General Dental Service.
Referrals for dental extraction(s) must include relevant radiographs (see ‘How to refer’ section).
Who not to refer:
The Adult Dental Anxiety Management Service (ADAMS) will not accept referrals for the following:
- Patients requiring / requesting:
- Private treatment options
- Implants
- Cosmetic dentistry
- Molar endodontics or fixed prosthodontics under conscious sedation or general anaesthesia
- Hygiene therapy in isolation under conscious sedation or general anaesthesia
- Conscious sedation solely to facilitate denture construction in those with a severe gag reflex.
- Patients with a failed local anaesthetic without a medical diagnosis.
- Patients (including those with dental anxiety), who require oral surgery. Referral should be made to ‘Oral Surgery’ via SCI Gateway.
- Patients with severe or significant special care need(s). Referral should be made to ‘Special Care Dentistry’ via SCI Gateway.
- Patients under the age of 16 years with dental anxiety. Please consult the referral guidance for ‘Paediatric Dentistry: Routine care’.
- Patients resident outwith the boundaries of NHS Lothian.
How to refer:
Referrals to the Adult Dental Anxiety Management Service (ADAMS) are only accepted from General Dental Practitioners (GDP).
- GDPs providing NHS dentistry must refer to the ADAMS via SCI Gateway. Any other route of referral will be rejected.
- If you are a private GDP and do not have access to SCI Gateway, please download, complete and send the referral form .
- Please note that the secure transmission of emails containing patient information is the referrer’s responsibility
For other primary and secondary health and social care providers wishing to refer to the ADAMS, please advise the patient to register with a GDP in the first instance. Information on how to register with a dentist can be found on the NHS Lothian Internet.
Referrals should be completed as fully as possible, with poorly completed forms rejected. When referring please ensure the following:
- A clear treatment plan is included.
- Recent and relevant radiographs are attached. Please upload with the patient’s name and date taken.
- If a treatment plan and radiographs are not included, then a reason provided for this.
- Optimum oral health achieved prior to referral.
Relevant radiographs / images should be included in your referral. These can be sent as an ‘attachment’ in SCI Gateway (maximum file size of 2MB, with a total attachment capacity of 5MB). If you are not registered with SCI Gateway, have images exceeding the file size or have relevant non digital images, please use an alternative option for the transfer of images
Please note that:
- It remains the responsibility of the referring GDP to provide or secure any necessary treatment or advice (including emergency / urgent care) until the patient is assessed by the ADAMS.
- The GDP will remain the first point of contact for all emergency / urgent care.
- All patients should have their oral hygiene and diet optimised under the care of their GDP prior to referral. Patients with poor plaque control or non-compliant with good oral hygiene regimens could have their treatment options greatly limited and access to conscious sedation / general anaesthesia declined.
- Patients identified as having an outstanding financial balance with our service will not be accepted.
Discharge criteria:
Patients will be discharged from the care of the Adult Dental Anxiety Management Service (ADAMS) for the following reasons:
- Their care can be reasonably delivered in a GDS setting.
- They have completed a course of treatment with the ADAMS.
- They fail to attend or repeatedly cancel their appointments at short notice. The referrer will be duly informed. For patients still wishing to be treated by the ADAMS, a new referral will be necessary.
