Meet special needs dentist Dr Lydia See

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special needs dentist Dr Lydia See
Dr Lydia See knew from early on her choice of career path was the right one. Photo: Glenn Hunt

Dr Lydia See, one of only a handful of special needs dental specialists in Australia, reveals what drives her to care for people in this growing yet under-serviced sector. By John Burfitt

Queensland dental specialist Dr Lydia See wasn’t aways convinced that dentistry was the right profession for her. On leaving school, she initially studied engineering and media, but then seeing the impact of effective medical care steered her into health. After considering medicine and podiatry, she settled on dentistry as her major.

But it was while doing her Master’s in Geriatric Dentistry at the University of Southern California (after graduating from the University of WA Dental School in 2010), followed by a Doctor of Clinical Dentistry in special needs dentistry at the University of Queensland, and stints of dental volunteering in between, that Dr See really felt she had indeed chosen the right career path.

“I was always convinced I should transfer into medicine, but once I started treating patients with special needs and understood the impact special needs dentistry can make, I felt like this is where I am meant to be,” she says. 

The Australian Health Practitioner Regulation Agency (Ahpra) defines special needs dentistry as a branch of dentistry concerned with the oral health care of people with an intellectual disability, or medical, physical or psychiatric conditions that require special methods or techniques to prevent or treat oral health problems or where such conditions necessitate special dental treatment plans.

Dr See graduated as a specialist at the end of 2023 and is one of only a small cohort of special needs dentists. According to the Australian Society of Special Care in Dentistry, there are only 26 special needs dentists in Australia. In 2013, there were 15.  

Realising the extent of the need in this sector was largely why Dr See decided to specialise. She had also been active as a volunteer in the Tzu Chi Foundation delivering general and dental care to socially disadvantaged people.

Our special needs population often have great difficulties to self-care or have been unable to undergo routine dental visits, so their oral health has suffered. One of the reasons why there’s such high demand for this sector of our population to get dental treatment is because of access.

Dr Lydia See, special needs dentist, UQ

“As dentists, we came into health care because we want to contribute and help people, and the people I see who really need the help are in this sector,” she says. “Since I developed the skills that can change the quality of another person’s life, then this is worth doing.

“Our special needs population often have great difficulties to self-care or have been unable to undergo routine dental visits, so their oral health has suffered. One of the reasons why there’s such high demand for this sector of our population to get dental treatment is because of access.”

She says issues around access, especially for those who are unable to present for physical appointments at dental clinics, or when consultation and treatments are deemed too difficult by carers and practitioners, can see patients fall through the cracks. 

According to the 2023 ‘Oral health and dental care in Australia’ report, around 12.5 per cent of people aged under 65 with a disability who have needed to see a dental professional in the previous 12 months have been on a public waiting list for dental care. This rate is highest (19.5 per cent) among those with severe or profound disability.

Dr See works at the University of Queensland, lecturing in special needs dentistry and exploring the use of silver fluoride in aged care dentistry. She is involved in the clinical supervision of dental students and is planning later this year to enter private practice to offer her specialist care. 

“One of my goals as a specialist is to ensure effective oral healthcare becomes more easily available for the special needs population,” she says. “We really need to find a model of care that works sustainably.”

A multi-disciplinary approach with dentistry integrating into general health care would be the ideal situation. It would allow us to see patients in a different kind of workflow so we can cater for patients unable to come into appointments due to unexpected issues, unforeseen hospitalisations and their social or medical complexities.

Dr Lydia See, special needs dentist, UQ

Also high on Dr See’s agenda is the creation of special needs clinics or services that support other clinics which may not be equipped to manage patients with special needs. 

“A multi-disciplinary approach with dentistry integrating into general health care would be the ideal situation. It would allow us to see patients in a different kind of workflow so we can cater for patients unable to come into appointments due to unexpected issues, unforeseen hospitalisations and their social or medical complexities. All of that comes down to funding, but I hope there might be room to open up this discussion.” 

The reality of delivering care to special needs patients is not, as Dr See reveals, without significant challenges. She says a number of strategies need to be utilised, including adopting a calm approach to communicating management plans and also building rapport with the patients. 

“We have to factor in the patient’s medical, psychological and social circumstances before we do anything,” she explains.

She cites the example of one patient, a 30-year-old woman with autism, who arrived at her first appointment wearing a Disney T-shirt. Dr See soon discovered the key to overcoming the patient’s aversion to dental work was connecting through the use of Disney music.

“We developed this game where we played versions of Disney songs and asked her to guess what each one was and what was coming up next,” she says. “We created an environment where the patient did not feel like she was even at the dentist. Over subsequent visits, she came to trust me to undertake complex dental procedures, and it was building that rapport that made all the difference.”

It’s important to never forget why we are doing our work in dentistry as it can make the most significant differences in our patients’ lives. To be a part of that journey and know you’re one of the people to have contributed to a patient’s recovery is so rewarding.

Dr Lydia See, special needs dentist, UQ

As part of her specialty training, Dr See recently completed her Doctor of Clinical Dentistry (Special Needs Dentistry) research thesis which explores the clinical effectiveness of silver fluoride in adults with special needs.

“I was introduced to silver fluoride when I was doing my master’s in geriatric care and saw how easy it was to apply and control caries, so I decided we needed to look further at it in a clinical study,” she says.

The preliminary results from the study, which are currently under peer review, are promising when it comes to the effectiveness of silver fluoride in dental decay management for adults with special needs.

“I want to come up with a clinical protocol that is easy to use for practitioners. It is especially useful in slowing down the rate of decay, and that gives clinicians the time to do restorative work so when it comes time to drill and fill, the decay is at least under control with potential for cavity preparation to be minimal.”

With her specialist clinical career about to move into high gear, Dr See says she wants to be part of a change she feels is taking place in the Australian dental landscape.

“It’s important to never forget why we are doing our work in dentistry as it can make the most significant differences in our patients’ lives,” she says. “To be a part of that journey and know you’re one of the people to have contributed to a patient’s recovery is so rewarding. 

“I always remember some of the mentors I had when I was just starting out in volunteering, and they showed me how one person really can create a ripple effect to make a difference in their community. Imagining what we could achieve into the future as a profession is something I never want to lose sight of.”

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