As lead dentist in the Community Special Care Dental Service, hosted by King’s College Hospital, Sanj Satheesan looks after the teeth of adults and children with disabilities and complex medical needs.
Meet Sanj
Tell us about the Community Special Care Dental Service
We see patients who may otherwise find it difficult to access care – because they are autistic or have a severe learning disability and would just find a traditional high street dental practice challenging.
We also provide dentistry to children who have a high level of tooth decay. And we work with vulnerable patients such as those experiencing homelessness. We’re based within health centres and hospitals, where we can support our patients in the right kind of environment. We go out and do home visits too.
What’s the best thing about the role?
It’s a job where you feel that you can really make a contribution to someone’s care and see a difference. You’re really focusing your skill set on patients who are vulnerable.
Is there a story that illustrates the benefits of the service?
I treated a young autistic man who is non verbal. He wouldn’t enter a dental surgery so we arranged for him to come to one of my community clinics with his mum. I grabbed some PPE, disposable mirror and torch and with my dental nurse, we went to see him in the car park, where I was able to identify a dental abscess from a molar tooth that needed treatment.
I treat patients with special care needs under general anaesthetic at Kingston Hospital so I set this up. I arranged for an anaesthetist to give a sedative drink in the car park. While he was asleep we were able to take full X-rays, carry out the extraction and give all his other teeth a good clean. We were able to benefit his overall health through this kind of planned care.
How do your home visits work?
Another patient was an elderly lady in her 90s in a care home. The staff had noted that a tooth had broken and she was having difficulty eating and in some discomfort. We were able to do an extraction for her at the home with a local anaesthetic. The treatment went very well so that was a nice resolution.
Why did you choose dentistry as a career?
I attended a comprehensive school in east London. I was studying science A levels and had thought about medicine but dentistry was introduced as an option by a careers advisor. It felt like a good fit – something that could make a difference in people’s lives. I went off to study at Guys Dental Hospital, graduating in the late 90s.
I worked in an NHS practice for a couple of years. I enjoyed it but, working nine to five, the days seemed to merge into one and I’m not business-minded, so running a practice was never my ambition. I was exploring options when a post came up for community dentistry working in the NHS in London and I thought, ‘let me give that a try’.
What challenges are you seeing at the moment?
As a society, we’re living longer acquiring more complex medical problems. When I first graduated, 90% of elderly patients had full dentures. That’s becoming very rare. People are holding on to their teeth into their 90s, 100s, but the teeth are starting to fail so sometimes require quite complex dentistry.
And a large number of referrals we get are for younger children. We have a very high decay rate within London so we see a lot of children who are fit and well but require fillings and extractions.
What are your top tips for good oral health?
It comes down to things we’ve all known about for a long time. What feeds decay is sugar so healthy eating balanced against and good oral hygiene – brushing with a fluoride toothpaste twice a day. It is a good idea to have regular check-ups but that doesn’t need to be six-monthly. If you’re a healthy adult, with good dental hygiene, every year to two years would be sufficient.
How easy is it to find an NHS dentist?
Although we hear stories of access to NHS dentistry being very difficult in some parts of the country, in south west London there are NHS dentists accepting new patients. You can find out more on the NHS website How to find an NHS dentist – NHS. Unlike registering with a GP, you don’t have to use a dentist within your local neighbourhood or postcode.
What if someone needs urgent care?
London is blessed to have a very good urgent dental care service. If you need to be seen, and can’t get to your dentist, visit NHS 111 or phone 111 if you can’t go online, even if it’s an evening, weekend or bank holiday. A dental professionals will either give advice over the phone or arrange a face-to-face visit in one of our urgent dental hubs.
If not dentistry, what would have been your plan B?
I did enjoy sciences and maths at school so I might have explored that. But dentistry is a great career. When you’re young, you think of it in terms of working in a high street practice but there are so many more specialties including hospital care and research.
What about when you’re not being a dentist?
As a child, before we moved to London, we lived around Ross on Wye on the Welsh-English border, and I’ve always loved the great outdoors. Now my kids are older, I’m finding my passion for that once again, getting out and about a lot more, and spending time in the garden.