Journal of Disability and Oral Health

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Cover Date:
March 2013
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Audit of Clinical holding in Special Care Dentistry

Doi: 10.4483/JDOH_017Kerr05

Abstract - Background: Clinical holding describes the use of physical holds to assist or support a patient who is receiving care or treatment. Aim: To evaluate the use of clinical holding within the Department of Sedation and Special Care Dentistry (DSSCD), Guy’s and St Thomas’s NHS Foundation Trust. Objectives: To compare the use of clinical holding with the British Society for Disability and Oral Health clinical holding guidelines (BSDH, 2009). Method: Staff were trained in the use of clinical holding positions to standardised levels: level 1 (least restrictive); level 2 (moderately restrictive); level 3 (most restrictive); and head hold. Results: Data sheets from 19 patients were collected over a four week period: level 1 = 50% (n=9); level 2 33% (n=6); level 3 6% (n=1). Eight head holds were recorded, in two cases holding the patients head was the only intervention required. The majority of patients (74%, n=14) who had clinical holding did not have the capacity to consent for treatment. In 64% (n=13) of cases, use of clinical holding was planned prior to the intervention. For 26% (n=6) patients, the clinical hold was unplanned. The justification for use of clinical holding was: 58% (n=11) to allow treatment in an uncooperative individual; 26% (n=5) to reduce uncontrolled movement; 32% (n=6) to prevent the patient harming themselves or another individual. Conclusions: The results of the audit were positive, showing that the majority of clinical holding interventions used were at level 1. Clinical holding was effective in enhancing treatment outcomes and reducing the need for general anaesthesia.

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B Kerr, J A Edwards, S Moosajee, Z Shehabi, S Rafique

Articles from this issue

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  1. Editorial
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  1. A critical appraisal of the literature on Palatal Plate Therapy for orofacial dysfunction in patients with Down syndrome
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  1. A case of tooth wear and self-reported local anaesthetic insensitivity in a patient with Ehlers-Danlos Syndrome
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  1. Audit of Clinical holding in Special Care Dentistry
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