Empowering people with disabilities

Catherine Waldron

After many years working as a dental nurse and dental hygienist, Catherine Waldron joined the DDUH and ultimately became Director of the dental hygiene programme. She recently completed a PhD on the oral health of people with disabilities.

What led you to dental nursing, and specifically for people with intellectual disabilities?
I was lucky to be in school with the daughter of the late, great Colm O’Sullivan, who gave me work experience. He was so supportive of dental nurses at the time, in the late 70s. He could really see the role that they could play and that inspired me to apply for dental nursing. My interest is in disabilities in general and not just intellectual disabilities. When I went to Glasgow to train as a dental hygienist, it was a very big part of our training. It was so rewarding, and also gave me the confidence to develop rapport with patients with disabilities and understand the issues that they face. I also have a brother with an intellectual disability.

Can you describe your research into oral hygiene for people with intellectual disabilities?
I looked at what kind of interventions were out there, and if there was any evidence supporting particular interventions. It was important to look at how these interventions really impacted on the people with the disabilities, how they improved their quality of life, how they supported them to make changes to their behaviour and habits that would help them become more empowered in relation to maintaining their own health. I did a number of systematic reviews, a scoping review of interventions of any kind for people with disabilities, then focused it in for the Cochrane Review on people with intellectual disabilities and oral hygiene. My reason for focusing on that was that there were a lot of interventions in that area, but also the basis of any good oral hygiene routine is that if we can get people brushing their teeth, hopefully it will impact on all the other elements. Then I did a realist review, which focused on, not just if these interventions had an impact on oral health, but why they worked in some settings and not others, and who they worked for. For me, the real interest was in the long-term impact on people’s quality of life and their ability to function well.

What are the particular challenges for dentistry for this cohort of patients in Ireland?
It’s about access to care and to acknowledge that each group of individuals with a specific disability may require different supports. It’s also about providing each person with a disability with a dental home so that there’s somewhere that they can go to easily that’s accessible to them, that can identify their specific needs and, if they need specialist care, that the dental professionals know what the care pathway is.
It’s important that everybody has education and training in that aspect, so that undergraduates of all the dental team are trained in relation to identifying the needs, are aware of the inequities and challenges that people with disabilities have, and feel a responsibility to advocate for them.

What should Government be doing to support oral health for people with intellectual disabilities?
The major step has been taken with the development of the national oral health policy. It now needs to be implemented. Coming from a non-dentist background, I think some of the restrictions placed on the scope of practice of both dental nurses and dental hygienists should be lifted, so that they can properly use all the skills they have, but also to expand the scope of their practice so that they can provide care in the community. A focus on prevention is something that those team members can readily get involved in.

How do you think the IDA can contribute?
They’ve been working hard over the last couple of years in relation to drawing attention to the number of dentists that are leaving the DTSS. I’ve benefitted myself from the support that the IDA has given to research. I was involved in the brushmyteeth.ie project that both the IDA and Wrigley supported.

Catherine is a serial volunteer, who has always been actively involved in her professional bodies, and is current President of the Irish Society for Disability and Oral Health. She enjoys walking, bird watching and loves to be in outdoors.
Catherine thanks the role models who have influenced her in her career: her PhD supervisors June Nunn and Caoimhin Mac Giolla Phadraig; her colleague Karin Nylund in the DDUH who encouraged her research and education; and Michael O’Rahilly, her first employer, who made dentistry so interesting. Catherine highlights the need for further education for dental nurses and dental hygienists.