Dental care for housebound people

1. Request a visit in England

Start with your usual NHS dental practice and explain that you need assessment at home because of physical or mental disability. Ask whether the practice offers domiciliary care or can refer you to the community dental service. If you have no dentist, your local integrated care board can advise about local NHS dental access. Referral rules are local: Kent’s NHS service accepts referrals from healthcare professionals and self-referrals from patients or carers, while Shropshire’s community service requires a health professional to refer. Ask your own service which route applies before completing a form. Explain the difficulty travelling and whether pain or another change makes the request urgent. Ask who will contact you after referral and what to do if symptoms worsen before the appointment.

2. Request a visit in Scotland

Contact the dental practice you normally attend and ask about home treatment or referral to your NHS board’s Public Dental Service. Use the board’s dental enquiry route if you do not have a dentist. NHS Borders, for example, offers domiciliary care where appropriate for housebound patients and accepts referrals from health and social care professionals. Its domiciliary guidance asks for clear justification of the need for a home visit and a completed assessment form. Explain how health, mobility or mental health prevents surgery attendance, rather than saying only that transport is inconvenient. Ask a dentist, GP or another professional involved in your care to clarify the local referral process. The Borders route is a local example; use the arrangements for the NHS board where you live.

3. Request a visit in Wales

Ask your regular dentist or local health board’s Community Dental Service about an assessment for domiciliary treatment. Explain why additional needs prevent you travelling to a surgery or clinic and ask which professional should make the referral. Cardiff and Vale’s service, for example, supports vulnerable people with moderate to severe additional needs who cannot receive care through a regular general dental practitioner. It provides home visits when additional needs prevent travel, and its clinics operate through referrals. This describes that health board’s service, rather than a promise that every Welsh service uses the same form. Ask the team serving your address about eligibility, the information needed and how to obtain urgent dental help while waiting. Keep any referral acknowledgement so you know which team is handling the request.

4. Request a visit in Northern Ireland

Ask your usual dentist whether they can treat you at home under Health Service arrangements. Nidirect explains that a general dental practitioner may provide treatment at your home or temporary residence when your condition requires it and they agree to accept you for Health Service care. Alternatively, a community dental service may be able to visit; your doctor or a local dentist can give you contact details. Confirm explicitly that the proposed visit is Health Service care, since a home visit is not automatically an NHS arrangement. Describe your disability or medical condition, the problem with getting to a surgery and the dental concern. Ask what treatment is possible outside a surgery and how to arrange further assessment if equipment or facilities at home are unsuitable.

5. Prepare the medical history and the room

Ask the visiting team what information and arrangements they need before coming. Kent’s NHS guidance asks for a current medical history, medicines and allergies, the doctor or specialist’s details, and the physical, mental or social reasons for a home visit. Complete the requested information accurately and tell the team about communication support or an interpreter. If the person needs assistance moving or being supported during the appointment, arrange for their usual helper to be present. Ask how to provide a private, suitable treatment area and explain any access difficulties in advance. Kent’s guidance specifies access to water and electricity, ventilation and keeping pets away from the treatment room. Check your own team’s instructions rather than trying to set up dental equipment yourself.

6. Keep everyday cleaning manageable

Brush all tooth surfaces with fluoride toothpaste, including the inside, outside and chewing surfaces. NHS advice is to brush twice daily for about two minutes, last thing before bed and on one other occasion. Spit out excess toothpaste afterwards without immediately rinsing with water. If grip, memory or mobility makes brushing difficult, ask the visiting dental professional to demonstrate a routine the person and their helper can manage. Ask for individual advice about cleaning between teeth, dentures and swallowing difficulties instead of assuming that one method suits everyone. Explain what is already manageable and which part causes discomfort or distress. Keep the dental team informed if the person cannot tolerate the usual routine, so the advice can be tailored to their needs.

7. Agree the treatment and charge before it begins

The first home appointment may be an assessment rather than completed treatment. Ask what can be provided safely where you live, which work would need a clinic, and how a follow-up would be arranged. Kent’s NHS service explains that some fillings, denture work, extractions and cleaning can be provided at home, but each person is assessed and some procedures need a hospital or clinic. Check the NHS or Health Service charge and any exemption before agreeing to treatment. England’s band charges differ from the Welsh care-package system and from Scotland and Northern Ireland’s percentage contributions. Use [[help-with-nhs-health-costs|help with NHS health costs]] to explore eligibility for help and ask the dental team which evidence they need. Request the individual treatment estimate rather than using a headline charge as the final bill.

8. Check charges and urgent symptoms

Ask whether care is under NHS arrangements and if a charge applies before treatment. Charges and exemptions vary; see the guide to help with NHS health costs. Seek urgent dental advice for severe pain, facial swelling, bleeding or trauma. “Immediate action required: Call 999 or go to A&E if you: are finding it hard to breathe, speak or swallow; have a swollen or painful eye, or suddenly start having problems with your eyesight; have a lot of swelling in your mouth; are finding it hard to open your mouth.” “Urgent advice: Ask for an urgent dentist appointment or get help from NHS 111 if: you think you have a dental abscess.”

9. Do not wait for a routine visit with an abscess

A dental abscess needs urgent treatment by a dentist and does not resolve by itself. If you suspect an abscess, contact the dentist or the urgent dental route rather than waiting for a planned home visit. Tell the service that you are housebound and describe the symptoms so it can advise on a suitable assessment. The NHS immediate-action wording is: “Immediate action required: Call 999 or go to A&E if you: are finding it hard to breathe, speak or swallow; have a swollen or painful eye, or suddenly start having problems with your eyesight; have a lot of swelling in your mouth; are finding it hard to open your mouth.” Use [[dental-care-dry-mouth-and-dentures|dental care, dry mouth and dentures]] for ongoing mouth-care questions after urgent needs have been dealt with. Ask the team arranging routine care how changes in symptoms should be reported between visits.

Common questions