posted 3 November, 2023

Dental Health Unit

The Dental Health Unit is based in the Outpatients Department on the ground floor of the Royal Manchester Childrens Hospital.

Our Specialist Dental Services are available for children with medical conditions referred by health professionals.

Patients accepted for assessment may be offered a face to face, telephone, or virtual appointment.

Further guidance regarding referrals can be found below, or by clicking here.

How to find us

Address: Dental Health Unit, Royal Manchester Children’s Hospital

Dental Health Unit, Outpatients on ground floor, Royal Manchester Childrens Hospital, Oxford Rd, Manchester M13 9WL (Main Entrance on East Rd)

Click here for more information on how to reach us.

Ground floor of Royal Manchester Childrens Hospital

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Meet the team

  • Dr Kay Hood – Consultant in Paediatric Dentistry & Specialty Lead for Dentistry, RMCH
  • Dr Cara Miller – Consultant in Orthodontics
  • Dr Jessica Cooper – Academic Clinical Fellow and Specialty Registrar
  • Dr Allyson Shepherd – Specialist in Paediatric Dentistry
  • Dr Carly Dixon – Specialty Trainee in Paediatric Dentistry
  • Dr Catherine Watts – Specialty Dentist in Paediatric Dentistry
  • Dr Vicky Weblin – Specialty Dentist in Paediatric Dentistry
  • Dr Lisa Clarke – Specialty Trainee in Paediatric Dentistry
  • Dr Andrew Fulton – Specialty Trainee in Paediatric Dentistry
  • Dental Core Trainees – (these are rotating posts on an annual basis)
  • Cath Willbur – Dental Secretary
  • Lesley Pinner – Lead Dental Nurse
  • Jo Harrop – Receptionist
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Information for patients

What is Paediatric Dentistry?

Paediatric Dentistry is a dental specialty providing care to patients from birth through adolescence for oral and dental diseases.

This can include everything from advice, basic treatment under local anaesthetic, to complex treatment with our patients completely asleep (general anaesthesia).

For more information regarding Paediatric Dentistry in general, including oral health advice, please visit the British Society of Paediatric Dentistry Website.

Paediatric Dentistry at Royal Manchester Childrens Hospital

At the Royal Manchester Childrens Hospital, we provide comprehensive oral and dental care for Paediatric patients under 16 years old with complex medical needs.

We accept referrals for patients 0-16 years old with Complex Medical Conditions which may affect the provision of dental care.

We offer a range of clinical services including:

  • general Paediatric Dentistry consultation clinics – for routine referrals and follow-up patients
  • treatment under local anaesthesia or inhalation sedation
  • comprehensive treatment under general anaesthesia
  • special interest clinics
    • multi-disciplinary clinic with Orthodontic Department

Initial patient appointments follow referral by a dentist, doctor or other healthcare professional.  Please note that there is no ‘walk in’ emergency service and all appointments are scheduled and booked.

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Changing or Cancelling your appointment

If you need to change or cancel your appointment, please tell us as soon as possible by calling the Dental Health Unit reception: 0161 701 9006 or 0161 701 9087
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Before your first visit

Before your appointment, please have a think about what is important to you and your child, and what help you are looking for from the Dental Health team.

Sometimes children’s behaviour can change when they have oral or dental issues, so having a think about this beforehand can help us quickly identify issues that may be affecting them.

If you have any photographs of your child’s oral or dental condition, e.g. on your phone, please bring these with you.

Please follow the instructions in the appointment letter including any adjustments linked to the pandemic. It is important that your child is brought by an adult with parental responsibility, so that consent forms can be signed if required, otherwise treatment may be delayed.

If your child is experiencing pain, swelling or other severe symptoms relating to their oral health, please contact your current dentist or call NHS 111 if your child is not currently registered with a dentist.

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At your first visit

Our face to face clinics are carried out by a member of the consultant-led Paediatric Dentistry – Dental Health Unit team. The clinician will ask questions about your child’s symptoms and concerns, as well as detailed questions about their medical background. Please have a list of any medications your child is taking and drug allergies that they have had.

We make every effort to start your consultation on time. For face-to-face appointments, please arrive 10 minutes before. If you are more than 20 minutes late for your appointment, you may not be seen.

Appointments are of variable length and may take over an hour. If your child’s condition is more complex, their appointment may take longer.

We will discuss your child’s oral health concerns with yourself and your child, and undertake an examination of the mouth. We are highly flexible and will undertake this in a way that is suitable to your child’s needs.

We may also take x-ray images of your child’s teeth/mouth to aid diagnosis and treatment planning.

At the initial consultation appointment, no dental treatment will be undertaken, so please reassure your child if they are anxious. 

Once there is a diagnosis your child’s treatment options will be discussed with you. It is important that you ask as many questions as you need to help you understand your child’s diagnosis and management.

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After your first visit

You will receive a copy of the clinical letter, which will also be sent to your referring clinician, and other medical professionals involved in your child’s care. This will include details about your child’s oral and general health, the examination, any investigations undertaken, and the overall treatment plan for their oral and dental care.

We may request our medical colleagues arrange for further investigations, such as blood tests, to help us provide treatment to your child. We may also refer your child to other medical or dental specialties for assessment.

Sometimes we refer patients to Community Dental Services for provision of treatment, ongoing shared care, or once we have provided treatment in the Dental Health Unit.

These services are local centres with experienced dentists who have the advanced skills and facilities to provide care to patients with complex needs. We will always discuss their involvement in your child’s care with you before making such a referral.

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Treatment

Treatment is provided in the same clinic as the one you visited for your child’s consultation appointment.

  • Please arrive 10 minutes early, so that we can check you in and update any relevant details.
  • Please ensure your child eats and drinks as normal prior to the appointment.
  • Please also ensure they take any medication as prescribed, unless advised otherwise.

Treatment is sometimes carried out under local anaesthetic to ensure it is painless.

This involves applying a small amount of local anaesthetic gel to the gum first. This helps to make the injection more comfortable. Then, to make the area completely numb, an injection is given with either a small needle or with a device call the Wand.

The Wand is a computer controlled device that can drip local anaesthetic into the gum around a tooth, and is often well tolerated by cooperative young children.

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Treatment under Inhalation Sedation

Sometimes we also provide inhalation sedation or ‘happy air’ to our patients, to help relax them. This is a form of light sedation. Your child will not be asleep.

It is a mix of nitrous oxide and oxygen breathed through a nosepiece. This helps your child to feel relaxed and accept treatment.

Your child will be awake and conscious throughout the procedure and will be able to talk.

Inhalation sedation takes a few minutes to become effective and also a few minutes to recover from at the end of the procedure.

Inhalation sedation is a suitable form of sedation for most children.

Before the appointment

Please contact Dental Department reception if your child develops a cold (inhalation sedation does not work if a child has a cold or a blocked nose).

On the day of the appointment

Fasting is NOT required. Your child should have a light meal approximately an hour or two before the appointment

Please ensure they take any medication as prescribed, unless advised otherwise.

The patient must be accompanied by a responsible adult who has parental responsibility

After the treatment

After inhalation sedation, your child should avoid active sports, swimming, bicycling, dancing, playing in a playground or crossing the road on their own for the rest of the day. Please ask the dentist if your child can go to school after the treatment.

Find out more about inhalation sedation here.

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Treatment under General Anaesthesia

A general anaesthetic ensures that your child is unconscious and pain free during an operation. General anaesthetics are given by specialist anaesthetic doctors who look after the health of your child during the procedure.

If your childs dental care is suitable to carry out under General Anaesthesia, we will discuss this with you at their initial assessment.

We may liaise with your child’s other doctors and medical carers regarding special measures to support your child’s admission for treatment under general anaesthetic.

Before a general anaesthetic, your child’s medical health and suitability for general anaesthetic will be assessed by an anaesthetic nurse or anaesthetist.

On the day of surgery, your child will need to have not eaten or drank beforehand. You will be provided with specific instructions regarding this.

You will also have a further opportunity to meet the dental and anaesthetic team on the day before surgery.

Most surgeries are ‘daycases’, meaning your child will be allowed to go home on the same day. However, sometimes we require our patients to stay in overnight for observations after a procedure. We will always try to let you know if this is likely.

All General Anaesthetics carried out by the Dental Health Unit occur in the Royal Manchester Children’s Hospital.

For more information click here

Read out post operative instruction leaflet here.

The Royal College of Surgeons has created a free short story for younger children about having an anaesthetic. Click here to read it.

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Caring for your child during and after Oncology Treatment

Cancer treatment can involve surgery and/or chemotherapy and/or radiotherapy. These treatments, however can cause short and longer term effects on the mouth and teeth.

This can include effects such as a sore mouth and ulcers (mucositis), or impact how the teeth grow.

Oncology patients will often be referred to the Dental Health Unit for ongoing dental care while they are undergoing treatment. We will discuss how their treatment may impact them, and can provide any treatment required to ensure oral health.

Find out more here.

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Referrals

Routine Referrals

This section is for healthcare professionals considering a referral.

The Dental Health Unit accepts referrals for children with medical complexities under the age of 17 years.

We accept referrals for:

Dental and oral health conditions in Children with:

  • complex medical problems,
  • developmental problems, learning difficulties or behavioural problems, who are unable to cooperate for routine dentistry

Dental and oral health conditions may include:

  • Children who have sustained complex dental trauma (e.g. pulp involvement in immature teeth).
  • Children with congenital or acquired dental anomalies who may require complex restorative or orthodontic treatment (e.g. Hypodontia, Ameologensis Imperfecta, Dentinogenesis Imperfecta, Molar Incisor Hypominerisation, Micro/macro-dontia and delayed eruption).
  • Children with soft or hard tissue pathology such as ulceration, swellings, and cysts.
  • Children with non-contact tooth surface loss, requiring specialist intervention.
  • Children with periodontal problems.
  • Children with cranio-facial anomalies.
  • Supernumeraries, odontomes, impacted teeth, submerging teeth, abnormal frenal attachments, and tongue-ties which may require surgical management.
  • Pre-cooperative children who require extractions.
  • Children with extreme dental anxiety who have proven unable to co-operate with routine dental treatment.

For referrals from within the Greater Manchester Area please click here

For referrals from outside the Greater Manchester Area, if we are your nearest Paediatric or Consultant-led service, please refer via letter addressed to:

Consultant in Paediatric Dentistry

Dental Health Unit

Outpatients

Royal Manchester Children’s Hospital

Oxford Rd,

Manchester

M13 9WL

Please complete all parts of these referral forms and include any relevant radiographs or photographs.

Inappropriate/ inadequate referrals will be returned. Your compliance will avoid unnecessary delays in patient care.

Emergency/Acute Referrals

The Dental Health Unit does not have an Emergency service out-of-hours or weekends.

Children with acute pain, infection, bleeding or an acute dentoalveolar injury should see their local dentist or contact an emergency dentist via 111.

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Multidisciplinary & Special Interest Clinics

Paediatric Dentistry & Orthodontics

This monthly multi-disciplinary clinic provides a care plan for the management of children with complex medical background, who have issues with both their oral health and positioning of their teeth.

The clinic is staffed by a Consultant in Paediatric Dentistry, and a Consultant in Orthodontics, as well as junior clinicians.

Severe Haematology Clinic

This monthly multi-disciplinary clinic provides dental review of patients with severe haematological conditions, such as Haemophilia A and B, von Willebrands disease, and Thalassemia.

The clinic is staffed by a Specialty Doctor in Paediatric Dentistry, and colleagues from Paediatric Haematology.

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