Bariatirc Patients
Question:
How do you approach the sensitive subject of an individual’s weight and the maximum load on the dental chair? Has anyone had experience of equipment being damaged because of this issue and if so has the practice had to bear the cost of repair/replacement?
Answer:
We recently received a referral form from our CCG to refer anyone in this category, although it is very difficult, and I don't think we would feel comfortable asking someone’s weight, or offering to refer them!
Answer:
We have had same problem and since developed protocols for bariatric patients with evidence based research and legal approval.
1) The EU maximum weight limit for use with a dental chair is 22 stone, or about 140kg. This is with the mechanism moving (ie the back), if static and chair turned off can go to 24 stone. Chairs are often made to exceed this but this is an EU ruling and we have found that if we have an issue and have allowed someone over that weight we have breached EU law and as such are liable.
2) There are very good evidence based flow charts from West Midlands and Fife PCT's on dental bariatric care. Both have an outcome of anyone over 22st needs to be referred to a bariatric dental specialist centre for the patient’s best care.
3) Insurance wise you are not covered if you use the chair with a weight limit above 22st and as such no public liability, staff indemnity etc. It will be seen as negligence as you are using a using equipment outside of its prescribed use, and most importantly it will breach health and safety regulations for your patients.
It is a massive issue and one that is desperately under aware of.
Answer:
We have a policy as I said, we have a sign at reception and in the waiting room notifying patients of the limit and for their health and safety they need to inform us much as they would any other medical condition. It should not be an embarrassing question to ask as it is a medical problem and if you address it as such patients understand.
Answer:
We ask for the patients’ weight on our medical history form. We also take referrals as we have a bariatric chair as part of our special needs service. Our dentist are advised if they have anyone over the weight the chair can ‘cope’ with not to move the chair in case of collapse. The patients must be explained the reason of the consequences that may happen if they are treated on a chair that does not carry their weight, best delay treatment than have a claim made against you should they injure themselves. Your local commissioner should know who has a bariatric chair in the local area and how you can refer to them.
Answer:
In NHS Grampian we have the facility to refer a bariatric patient to ARI for treatment as they have specially adapted surgeries to cater for these patients. Perhaps your local referral hospital will have the same service, worth investigating as it would make the experience much easier for the patient as well.
August 2014
