posted 2 April, 2018

Paediatric Dentistry

The Department of Child Dental Health is based on the 2nd floor of the University Dental Hospital of Manchester.

We provide a Consultant-led Dental service for the diagnosis and management of oral health disorders in children and young people under the age of 16 years.

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: Department of Child Dental Health, 2nd Floor, University Dental Hospital of Manchester, Higher Cambridge St, Manchester M15 6FH

Contact number: 0161 393 7732

Click here for more information on how to reach us or click the map below to enlarge.

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Paediatric Dental Team

  • Professor Siobhan Barry – Professor and Consultant in Paediatric Dentistry & Specialty Lead for Paediatric Dentistry, UDHM
  • Dr Vidya Srinivasan – Consultant in Paediatric Dentistry
  • Dr Lucy McClean – Consultant in Paediatric Dentistry

There are a number of rotating Specialty Registrars, Specialty dentists and Dental Core Trainees, as well as Post-Graduate and Under-Graduate dental students in the department.

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Information for patients

What is Paediatric Dentistry?

Paediatric Dentistry is a dental specialty providing care to patients from birth through to 16 years old 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 University Dental Hospital of Manchester

At the University Dental Hospital of Manchester, we are a Consultant-led service which provides comprehensive oral and dental care for Paediatric patients under 16 years old.

We accept referrals for patients 0-16 years old with oral and dental conditions that cannot be managed in general practice.

We offer a range of clinical services including:

  • general Paediatric Dentistry consultation clinics – for routine referrals and follow-up patients
  • treatment under local anaesthesia, inhalation sedation or intravenous sedation
  • extractions under general anaesthesia
  • comprehensive treatment under general anaesthesia
  • special interest clinics
    • multi-disciplinary clinic with Restorative and 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 Department of Child Dental Health reception: 0161 393 7732
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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 Child 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.

Please note that there is no ‘walk in’ emergency service.

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At your first visit

Our face to face clinics are carried out by a member of the consultant-led Child Dental Health team. The clinician will ask questions about your child’s symptoms and concerns, as well as detailed questions about their medical, social, and dietary backgrounds. 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 via post, 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 Department of Child Dental Health.

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 either the open plan clinic you visited for your child’s consultation appointment, or in one of our side-surgeries.

  • 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 a small needle. This is provided in a way that minimises any discomfort your child may feel.

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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.

Inhalation sedation is not suitable when pregnant.

Before the Inhalation Sedation 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 Inhalation Sedation 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 under Inhalation Sedation

After inhalation sedation, your child should avoid active sports, including swimming, cycling, 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.

Read more about Inhalation Sedation here.

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Treatment under Intravenous Sedation

Intravenous sedation is a form of sedation we provide to some children over 12 years old.

It helps your child to feel really relaxed, making lengthy or complex dental treatment more comfortable and easy for them.

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

This type of sedation is given by specialist anaesthetic doctors who look after the health of your child during the procedure. They deliver the sedation through an injection, usually in the arm or the back of hand.

This treatment is provided in the Sedation Suites at the Royal Manchester Children’s Hospital.

If your child is suitable for treatment with Intravenous sedation, your dentist will discuss this with you at their initial assessment.

Read more about Intravenous 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 child’s 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.

General Anaesthetics carried out by the Department of Child Dental Health occur in either the Trafford General Hospital or the Royal Manchester Children’s Hospital.

Before your child’s 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. This may be by phone or in a face to face appointment.

On the day of the General Anaesthetic

  • For General Anaesthetics at the Royal Manchester Children’s Hospital, please attend Ward 76 on the First floor.
  • For General Anaesthetics at the Trafford General Hospital, please attend the Children’s Resource Centre on the Ground floor.

On the day of surgery, your child will need to have fasted before their surgery.

Please follow the general rules below:

  • Up to 6 hours before the anaesthetic, children can have food and formula milk.
  • Up to 4 hours before the anaesthetic, children can have breast milk.
  • Up to 1 hour before the anaesthetic, children can have sips of water only.

You will be provided with specific instructions regarding this.

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

You will usually be allowed to accompany your child to the anaesthetic room, and be there while they are put to sleep.

Once your child’s operation is over, we will bring your child to the recovery room and you can be present while they are waking up.

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.

After your child’s General Anaesthesia

We will provide verbal and written advice on how to look after your child after they have had their dental treatment under General Anaesthesia.

We will also discuss whether your child needs to be seen again in the Department of Child Dental Health

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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Referrals

The Department of Child Dental Health accepts referrals for children under the age of 16 years.

We accept referrals for:

  • Children with developmental problems, learning difficulties and behavioural problems, who are unable to cooperate for routine dentistry.
  • 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.
  • 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.

Children with complex medical problems which may affect the provision of dental care are seen at the Dental Health Unit, Royal Manchester Children’s Hospital.

We DO NOT accept referrals for:

  • Routine primary care (e.g. caries in cooperative children, endodontic treatment in permanent teeth with closed apex).
  • Root canal treatment in permanent molars unless there is good clinical indication for retention of the compromised tooth i.e. severe hypodontia.
  • Orthodontic extractions under GA.
  • We do not routinely accept referrals for tongue-tie unless there is a documented speech and language concerns from a Speech and Language Therapist
  • We do not routinely accept referrals for frenectomies unless request by an Orthodontist

For referrals from within the Greater Manchester Area please click here

Please note referrals will be triaged to the nearest local provider depending on service need (local anaesthesia, inhalation sedation or general anaesthesia)

For referrals from outside the Greater Manchester Area (if we are your nearest Paediatric or Consultant-led service) please click here.

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Emergency/Acute Referrals

The Regional Paediatric Dental Service does not provide a routine dental access service for children. If a child attends the Dental Hospital in pain they will be directed back to their local primary care provider. If they are not registered with a Dentist, they will be signposted to the NHS Direct local helpline (dial: 111) to emergency care. An appointment closest to home will be offered. If they attend the dental Hospital seeking routine care, the helpline will advise on which dental practice closest to their home has capacity.

Dental Practitioners wishing to make an emergency referral must telephone the Department and speak to the Triage team / Consultant in charge on that day, before sending a patient to the Dental Hospital.

Please ring 0161 393 7732 for advice on how we can best help your patient receive the appropriate care.

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

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Multidisciplinary & Special Interest Clinics

Hypodontia Clinic

This monthly multi-disciplinary clinic provides care for patients with missing teeth (hypodontia).

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

Transition Clinic

This multi-disciplinary clinic occurs every 3 months and provides a care plan when patients move from being under the care of Paediatric Dentistry, to the care of Adult Restorative Dentistry or another adult specialty.

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

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