{"id":3685,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/adultdentalanxietymanagementservice\/"},"modified":"2024-06-06T08:25:01","modified_gmt":"2024-06-06T07:25:01","slug":"adultdentalanxietymanagementservice","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dentistryoralhealthservice\/adultdentalanxietymanagementservice\/","title":{"rendered":"Adult Dental Anxiety Management Service"},"content":{"rendered":"\n<p>\u200b<strong>Information <\/strong><\/p>\n\n\n\n<p>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. <\/p>\n\n\n\n<p>The ADAMS accepts referred patients from their registered General Dental Practitioner (GDP) for a single course of treatment.&nbsp; Patients will be returned to their GDP when they are considered suitable for ongoing &#8216;continuing care&#8217;. &nbsp;<\/p>\n\n\n\n<p>&nbsp;The ADAMS offers a range of treatment modalities:&nbsp; <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Behavioural management techniques<\/li>\n\n\n\n<li>Inhalation sedation <\/li>\n\n\n\n<li>Access to intravenous sedation (dentist \/ anaesthetist led depending on <span style=\"text-decoration:underline\"><a href=\"https:\/\/www.asahq.org\/resources\/clinical-information\/asa-physical-status-classification-system\" target=\"_blank\" rel=\"noreferrer noopener\">ASA classification<\/a><\/span>)<\/li>\n\n\n\n<li>Access to general anaesthesia <\/li>\n<\/ul>\n\n\n\n<p>Please note that patients should <strong>not<\/strong> be referred for a specific treatment modality.&nbsp; The ADAMS will assess and determine the treatment modality most suited for the patient.&nbsp; <\/p>\n\n\n\n<p>Patients meeting our acceptance criteria are allocated to ADAMS clinics in date order.&nbsp; Where possible, the course of treatment will be carried out at the same clinic as the initial assessment.&nbsp; 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&#8217;s Hospital, Livingston.&nbsp; <\/p>\n\n\n\n<p>Treatment is provided under General Dental Service (GDS) terms and conditions with strict adherence to the Statement of Dental Remuneration (SDR).&nbsp; <\/p>\n\n\n\n<p>NHS fees apply to all unless the patient is <span style=\"text-decoration:underline\"><a href=\"https:\/\/www.nhsinform.scot\/care-support-and-rights\/health-rights\/access\/help-with-health-costs\" target=\"_blank\" rel=\"noreferrer noopener\">entitled to free dental treatment<\/a><\/span><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who can refer:<\/h4>\n\n\n\n<p>The Adult Dental Anxiety Management Service (ADAMS) only accepts routine referrals from General Dental Practitioners.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p>Registered patients requiring dental treatment whose dental anxiety \/ phobia necessitates behavioural or pharmacological management techniques beyond that provided in the General Dental Service.<\/p>\n\n\n\n<p>Referrals for dental extraction(s) must include relevant radiographs (see &#8216;How to refer&#8217; section).<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p>The Adult Dental Anxiety Management Service (ADAMS) will not accept referrals for the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients requiring \/ requesting:\n<ul class=\"wp-block-list\">\n<li>Private treatment options<\/li>\n\n\n\n<li>Implants<\/li>\n\n\n\n<li>Cosmetic dentistry<\/li>\n\n\n\n<li>Molar endodontics or fixed prosthodontics under conscious sedation or general anaesthesia<\/li>\n\n\n\n<li>Hygiene therapy in isolation under conscious sedation or general anaesthesia<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Conscious sedation solely to facilitate denture construction in those with a severe gag reflex.<\/li>\n\n\n\n<li>Patients with a failed local anaesthetic without a medical diagnosis.<\/li>\n\n\n\n<li>Patients (including those with dental anxiety), who require oral surgery.&nbsp;&nbsp; Referral should be made to&nbsp;<a href=\"\/refhelp\/guidelines\/OralSurgery\" target=\"_blank\" rel=\"noreferrer noopener\">&#8216;Oral Surgery&#8217;&nbsp;<\/a>&nbsp;via SCI Gateway. &nbsp;<\/li>\n\n\n\n<li>Patients with&nbsp;<strong>severe&nbsp;<\/strong>or&nbsp;<strong>significant<\/strong>&nbsp;special care need(s).&nbsp; Referral should be made to&nbsp;<a href=\"\/refhelp\/guidelines\/SpecialCareDentistry\" target=\"_blank\" rel=\"noreferrer noopener\">&#8216;Special Care Dentistry&#8217;&nbsp;<\/a>&nbsp;via SCI Gateway.<\/li>\n\n\n\n<li>Patients under the age of 16 years with dental anxiety.&nbsp; Please consult the referral guidance for&nbsp;<a href=\"\/refhelp\/guidelines\/PaediatricDentistryRoutine\" target=\"_blank\" rel=\"noreferrer noopener\">&#8216;Paediatric Dentistry: Routine care&#8217;.<\/a><\/li>\n\n\n\n<li>Patients resident outwith the boundaries of NHS Lothian.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>Referrals to the Adult Dental Anxiety Management Service (ADAMS) are only accepted from General Dental Practitioners (GDP).&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>GDPs providing NHS dentistry<strong>&nbsp;must refer to the ADAMS via SCI Gateway<\/strong>.&nbsp; Any other route of referral will be rejected.<\/li>\n\n\n\n<li>If you are a private GDP and do not have access to SCI Gateway, please download, complete and send the&nbsp;<a href=\"\/files\/sites\/2\/Oral-Health-Service-referral-form.docx\" target=\"_blank\" rel=\"noreferrer noopener\">referral form<\/a>&nbsp;.\n<ul class=\"wp-block-list\">\n<li><strong>Please note that the<\/strong>&nbsp;<strong>secure transmission of emails containing patient information is the referrer&#8217;s responsibility<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p>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.&nbsp; Information on how to register with a dentist can be found on the&nbsp;<a href=\"https:\/\/www.nhslothian.scot.nhs.uk\/Services\/Dentists\/Pages\/default.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">NHS Lothian Internet<\/a>.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Referrals should be completed as fully as possible, with poorly completed forms rejected.&nbsp; When referring please ensure the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A clear treatment plan is included.<\/li>\n\n\n\n<li>Recent and relevant radiographs are attached.\u00a0 Please upload with the patient\u2019s name and date taken.<\/li>\n\n\n\n<li>If a treatment plan and radiographs are not included, then a reason provided for this.<\/li>\n\n\n\n<li>Optimum oral health achieved prior to referral.<\/li>\n<\/ul>\n\n\n\n<p>Relevant radiographs \/ images should be included in your referral.&nbsp; These can be sent as an &#8216;attachment&#8217; in SCI Gateway (maximum file size of 2MB, with a total attachment capacity of 5MB).&nbsp; 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&nbsp;<a href=\"\/files\/sites\/2\/Quick-reference-guide-for-Transfer-of-Images-to-the-Oral-Health-Service.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">transfer of images<\/a><\/p>\n\n\n\n<p>Please note that:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>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.&nbsp;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The GDP will remain the first point of contact for all emergency \/ urgent care.&nbsp;<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>All patients should have their oral hygiene and diet optimised under the care of their GDP <strong>prior<\/strong> to referral.&nbsp; 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.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients identified as having an outstanding financial balance with our service will not be accepted.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Discharge criteria:<\/h4>\n\n\n\n<p>Patients will be discharged from the care of the Adult Dental Anxiety Management Service (ADAMS) for the following reasons:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Their care can be reasonably delivered in a GDS setting.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>They have completed a course of treatment with the ADAMS.<\/li>\n\n\n\n<li>They fail to attend or repeatedly cancel their appointments at short notice.&nbsp; The referrer will be duly informed.&nbsp; For patients still wishing to be treated by the ADAMS, a new referral will be necessary.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a rel=\"noreferrer noopener\" href=\"http:\/\/www.sdcep.org.uk\/published-guidance\/sedation\/\" target=\"_blank\">Conscious Sedation in Dentistry (SDCEP)<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;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<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3839,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[82],"class_list":["post-3685","page","type-page","status-publish","hentry","category-adult-dental-anxiety-management-service"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dentistry-oral-health-service\/adult-dental-anxiety-management-service\/\" rel=\"tag\">Adult Dental Anxiety Management Service<\/a>","rttpg_excerpt":"&#8203;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","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3685","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3685"}],"version-history":[{"count":10,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3685\/revisions"}],"predecessor-version":[{"id":19780,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3685\/revisions\/19780"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3839"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3685"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3685"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}