The rewards and challenges of Special Needs Dentistry

Like many dentists, Jee-Yun was drawn to the profession because of the unique combination of art, science and interaction with people. As a child, Jee-Yun loved sewing, musical instruments, but wanted a career that would be “intellectually challenging and rewarding in that I would be directly helping and building up relationships with patients”. 

I was confronted by the challenges faced by those living with special needs and their carers, and found great reward in turning compassion into action. I actually didn’t find out Special Needs Dentistry was a specialty until my fourth year of dental school, whilst at a Dental Public Health conference.

Jee-Yun says her interest in special needs originated from volunteering on a camp for children with special needs in high school and working part-time at an Australian Red Cross respite centre during university.

“I was confronted by the challenges faced by those living with special needs and their carers, and found great reward in turning compassion into action,” she recalls. “I actually didn’t find out Special Needs Dentistry was a specialty until my fourth year of dental school, whilst at a Dental Public Health conference. 

“This led to me undertaking my fifth-year elective placements at the Special Needs Dentistry Departments in Sydney and Melbourne and coming to the realisation that I could combine my profession with my passion for helping those living with special needs.”

Jee-Yun says her career choices have been driven by a strong belief in social responsibility and desire to tackle the oral health inequalities faced by those living with special needs.

Graduating from UWA in 2012, she sought to attain a good sense of the various dental needs of the community by working in regional and metropolitan, and government and private practice contexts. She worked with Dental Health Services WA in the North Perth Special Needs Clinic (seeing patients with intellectual disability) and the Domiciliary Unit (doing aged care facility visits). A position at the then newly opened Fiona Stanley Hospital came up, where Jee-Yun saw medically complex patients. Throughout these years, she also maintained private practice work to finesse her general dental skills.

It was fascinating working in a country where SND is so established at all levels of the healthcare system by a well-supported workforce of more than 300 specialists and learning UK evidence-based guidelines and public health policy. 

“During this period, I received an ADRF grant to research oral health delivery systems that integrate dentistry with the array of health and social services available for people with special needs, and performed voluntary dental work in various SND contexts,” she says.

“To gain an international perspective on what can be achieved (and also to get to know my British husband’s family better), I moved to London in 2017 to study the Masters in Special Care Dentistry at the Eastman Dental Institute, University College London,” she adds. 

“The UK is a global leader in SND clinical care and public health research. It was fascinating working in a country where SND is so established at all levels of the healthcare system by a well-supported workforce of more than 300 specialists and learning UK evidence-based guidelines and public health policy. 

“By that stage, SND well and truly felt like my calling, and so I moved from London to Adelaide to commence the Doctor of Clinical Dentistry. Needless to say, after almost five years away from home, I’m very excited to be returning to Perth.”

During her time in Adelaide, Jee-Yun says she was very blessed to be mentored by Associate Professor Sharon Liberali and work within a highly supportive team at the Adelaide Dental Hospital’s Special Needs Unit.

“South Australia has a robust, specialist-led SND service, a network of general dentists whom we support to provide shared care, and strong relationships with both public and private medical specialists,” she says. “I had the opportunity to work at the Adelaide Dental Hospital (medically complex and disability), Royal Adelaide Hospital (head and neck cancer multidisciplinary team and GA theatre sessions), Women and Children’s Hospital (transition clinic), Queen Elizabeth Hospital (in-patient, psychiatric and orthogeriatric care), community dental clinics, rural clinics, and domiciliary aged care. I also supervised final year dental students on their SND placements at the Adelaide Dental Hospital and Housing Choices Common Ground dental clinic (a free, volunteer-run service for refugees, victims of domestic violence and homeless people), and produced a research thesis on early detection of osteoradionecrosis.”

Hopes for Special Needs Dentistry in WA

Now she is back in Perth, Jee-Yun has returned to Fiona Stanley Hospital as a consultant in the Oral Maxillofacial and Dental Surgery Department.

When asked what she is hoping to achieve for Special Needs Dentistry on her arrival back in WA, she says she hopes to raise awareness of the scope of SND amongst the profession; support general dentists to feel confident and see the reward in treating people living with special needs; be involved in improving access to SND services; and expose current students to SND to encourage others to specialise (and return back to WA!). 

“There are only 26 AHPRA registered specialists in SND Australia-wide,” she says. “However, with an ageing population, increasing number of co-morbidities associated with increased life expectancy, improved survival rates of those born with disability, increasing number of people surviving acute and chronic medical diagnoses, and increased complexity of medical treatment, the population requiring SND care is rapidly ballooning beyond the capacity of the current specialist workforce and requires a whole-of-dental-team approach.”

Jee-Yun would like dental colleagues and peers to know that Special Needs Dentistry is an incredibly rewarding and intellectually challenging field for the clinician, which also meets a significantly underserved need in our population.

“When we grow to know our patients as people, it can be a very positive, fun, joyous and a humbling experience,” she says. “I have probably gained more from my patients than they have from me, and learnt so much from their resilience and tenacity.”

She adds the treatment planning and dentistry involved in SND is complex. “It requires extensive knowledge of evidence-based medical and dental guidelines; an appreciation of multiple overlying medical/social factors in a compromised oral environment; a good understanding of material science and strong clinical expertise (i.e. the ability to think outside the box – you need to know the rules to bend them!); and involves a more holistic and rational philosophy of care,” she says. 

“People living with special needs have greater unmet dental needs compared to the general population due to various patient, carer, dentist and health system factors. I would love to support other dentists to treat this pretty amazing population, whilst also being available to manage the more complex cases requiring specialist input.”

5 Minutes with Dr Jee-Yun Leung

Which three words best describe you?

Bubbly, motivated and caring. Though the nickname “Energizer Bunny” was coined by one of my patients and adopted by my Adelaide colleagues! 

What do you do in your spare time?
Swimming, exploring the picturesque wine and produce regions of SA, volunteering on the music team at my local church, and Zooming interstate/international family… but hopefully I’ll now have more time to reignite my love of dressmaking and learning French (and see family in-person).

If you weren’t a dentist, what would you be doing for a living?

I initially studied commerce and mathematics at university with the hope of becoming an actuary. So glad I did not end up pursuing that.

What is your favourite part of the world?

Living in London, I loved the global and diverse nature of the city and proximity to travel all over Europe. However, being away from Perth for a number of years makes one realise that home is where the heart is.

Is there anything that people might be surprised to learn about you?

I have managed to survive all the above without coffee addiction. In fact, I have only ever drunk one full mug of coffee in my life (due to a café mucking up my takeaway order)!