Speech app helps disabled people to communicate at the dentist

Published On Mon 16 Jun 2014 by Roddy Isles

Scottish scientists have developed a speech app which helps children and adults with learning and/or communication disabilities prepare for a visit to the dentist.

A visit to the dentist can be an anxious time for most people. But, for people with disabilities that affect communication, visits to the dentist can be particularly stressful.

The Stories at the Dentist communication system helps patients with a learning and/or communication disability to know what to expect when visiting the dentist and to be more involved in the decision making process concerning their care and treatment options.

“This app is already transforming patients' experiences in the dental setting,” said Gillian Elliott, Senior Dental Officer and Specialist in Special Care Dentistry at the Community Dental Service. “By improving communication, and therefore understanding, patients can become fully involved in decisions about their care. We have found that the app reduces anxiety as patients are fully prepared about what to expect at their dental visit.”

The system is the result of an eighteen-month long collaborative project between computing scientists, dentists and health scientists from the Universities of Dundee and St Andrews, NHS Tayside and Capability Scotland, funded by the Research Council UK Digital Economy. Patients and Community Dental staff across Tayside were involved in the design and evaluation of the app, which runs on an iPad.

The Stories at the Dentist project investigated whether the use of technology in the dental surgery can improve access to dental treatment.

The app allows a patient to interact with a customised ‘story’ about their next dental appointment. For some disabilities such as Autism, knowing ahead of time what will happen at a dental visit is particularly important. Stories are written from the perspective of the patient and photographs of people, places and equipment help to prepare them for the visit. For some patients, explanation of different treatment options or advice on how to care for their teeth at home may be given.

It is imperative that the dentist understands their patient’s concerns and fears so that they can offer reassurance and explanation. People with communication disabilities may find it difficult to express their feelings. The app allows patient to ‘Tag’ parts of the ‘Story’ that make them feel anxious or they have questions about.  The tagged story is used by the patient and dentist before treatment to discuss these issues.

The app serves as a tool enabling the building of rapport and understanding between a dental professional and patient making treatment less stressful for both the patients and the clinician.

The app can be accessed by other dental professionals, for example a dental hygienist seeing a patient for the first time or a new dentist in a practice. The app can store information about an individual patient’s likes or dislikes and can include other information such as how to communicate with the patient or conversation topics about a patient’s hobbies or family.

Professor Annalu Waller, from the University of Dundee’s School of Computing, said, “We have developed a proof-of-concept app which allows disabled patients to communicate more effectively with their dentists. Good communication between medical staff and patients is essential for successful treatment – technology provides a powerful tool to break down communication barriers which in turn reduces anxiety for both patient and professionals.”

Dr Lesley Scott, a community NHS dentist seconded to the project, said, “As a dentist, it is often difficult to know what an individual’s specific abilities, needs and concerns are and to keep track of these between appointments. By facilitating communication the app has the potential to make dental care a much less stressful experience for this group of patients and clinicians providing their care. This will undoubtedly result in improved dental health and wellbeing for these patients. Enabling patients to be involved as fully as possible in decisions concerning their care is our professional responsibility and we should make use of all available technology to ensure this.”

Capability Scotland Chief Executive, Dana O’Dwyer, said, “I know many people who use Capability Scotland’s services will welcome this innovative project which demonstrates the powerful role that technology can play in the lives of disabled people when it is used creatively. 

“It is so important that disabled people have equal access to good dental care and other health services and this project is helping to make that happen.  By overcoming communication barriers the Stories at the Dentist app will not only ensure a more positive experience of visiting the dentist but, more importantly, it will give disabled patients a greater say over their dental treatment and care.”

The long term aim will be to develop the prototype app into a technology available as a download.

NOTES TO EDITORS

Stories at the Dentist

A major challenge facing the health and wellbeing of people with intellectual disabilities (ID) is the level of anxiety experienced by both the disabled patient and the medical practitioners. When a patient with ID is anxious, they may become defensive and exhibit challenging behaviour when the professional attempts to treat them. As a result of this, the procedure may have to either be abandoned or the patient sedated. The need for sedation is a common problem in dentistry as patients with ID often require a general anaesthetic for simple dental treatment. This carries increased risks, a longer recovery time and increases the cost of the procedure to the NHS.

One reason for patients’ anxiety is the difficulty in communication between patient and practitioner. In particular, it can be difficult for medical professionals to provide patients with ID with information about the treatment they require in a way that they can understand. An inability to understand what is about to happen or to express feelings makes a visit to the dentist frightening and stressful. In addition, it is considered good practice to obtain informed consent or assent from all patients. However, clinicians are often unsure if a patient with ID has understood explanations of procedures. It is difficult for people with ID to understand how abstract information relates to them with the result that, compared to the general population, patients with ID find it significantly more difficult to make healthcare decisions.

This study was designed to develop a software tool to support people with ID to understand treatment procedures with the aim of reducing anxiety for both patients and clinicians, and to enable patients to be more involved in the decision making process. While this has the potential to produce benefits across the health service, this study focuses on dental health.

NHS Tayside

The role of the Public Dental Service encompasses clinical care, oral health promotion and epidemiology.  Clinical care is provided for priority groups (children, pregnant women and adults with special needs), safety net patients unable to access GDS care, and vulnerable adults, for example people experiencing homelessness.  Tayside PDS employs over 150 staff in 10 clinics across Tayside.

Capability Scotland

Capability Scotland campaigns with, and provides services to, disabled children and adults across Scotland, supporting them to achieve equality and have choice and control in their lives.

 

Roddy Isles
Head of Press
TEL: 01382 384910
MOBILE: 07800 581902
E-MAIL: r.isles@dundee.ac.uk