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Br Dent J. 2019 Aug;227(4):311-315. doi: 10.1038/s41415-019-0623-x.

Diagnostic overshadowing in dentistry.

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Barts Health, Consultant in Special Care Dentistry, The Royal London Dental Hospital, London, UK.
Barts Health, Lead Nurse for Learning Disability, The Royal London Hospital, London, UK.


Diagnostic overshadowing can be described as a concept whereby symptoms of physical ill health are mistakenly attributed by healthcare professionals to either a mental health or behavioural problem, or as being inherent in the person's disability. This can lead to a failure to diagnose and treat appropriately. Although widely discussed in medicine, this issue has not been previously highlighted in the dental speciality, yet it can lead to significantly detrimental general and oral health outcomes for vulnerable patients. This article focuses on the care of patients with learning disabilities and the prevention of diagnostic overshadowing in dentistry through the application of reasonable adjustments to care and education within the dental team.


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