What to do when referring a patient, better to read now ;)

[Guest guest]

What to do when referring a patient

Take a new medical history.

Examine the radiographs and clinical findings.

Explain to the patient why you want to refer them and to whom.

Referral letters

The following information is required:

Name, title and address of

person to whom you are referring the patient.

Patient's name, address

and Date of Birth (DOB)

Reason for referral.

The history of the

complaint

Request for advice and/or

treatment.

Any previous relevant

treatment carried out with dates.

Relevant medical/social

history.

Details of enclosures such

as radiographs

Specific referrals require further information:

Orthodontic referrals

Diagnosis

Patient's attitude to

treatment

Oral hygiene

Caries rate

Previous orthodontic

treatment

Radiographs and study

models

Oral surgery referrals

History of complaint

Suggested diagnosis

Indication of urgency

Relevant radiographs

Periodontal Referrals

CPITN Score

Mobility scores

Information on deep or

persistent pockets

Relevant Radiographs

Oral Hygiene History

Example orthodontic referral letter

Mr

Consultant Orthodontist

St 's Hospital

Chelmsford

01/01/04

Re: Miss Jane

10 Main Street

Danbury

CM3 7YR

DOB: 31/01/91

I should like to refer this 12-year-old girl for advice on the management of

her upper canine crowding. She is unhappy about the appearance of her teeth

and is prepared to wear an appliance.

She is a regular attender, and her oral hygiene is good. She is caries free.

All teeth are present on radiograph. She has a 3mm overjet with a complete

overbite.

The lower arch is well aligned. The upper arch has moderate anterior crowding

with insufficient space for the canines, which are erupting buccally.

Would it be reasonable to?

1. Extract upper 4's

2. Fit URA to retract upper 3's?

Jane has asthma and regularly uses a ventolin inhaler.

Thank you for seeing Jane.

Yours sincerely

Dentist BDS

Enclosures: 1 set study models, 1 panoral radiograph

Orthodontic waiting lists are long in some parts of the country, so refer as

soon as the problem becomes apparent and inform the patient that they may

have to wait some months for an appointment with an orthodontist.

Oral Surgery referral letter

Mr White

Consultant Oral Surgeon

St 's Hospital

Chelmsford

01/01/04

Re: Mr

24 Willow Avenue

Bicknacre

CM4 8RT

DOB: 11/06/49

This letter follows our telephone conversation earlier today.

This gentleman presented at the practice last week complaining of a

persistent ulcer on the side of his tongue. He reported that the ulcer has

been present for at least four weeks. It has caused intermittent tenderness.

On examination, the ulcer was located on the left lateral border of the

tongue and was 7mm in diameter. The edge of the ulcer was rolled and hard to

the touch.

Extra orally, there was no detectable enlargement of the sublingual or

submandibular lymph nodes. A sharp cusp from the nearby lower left first

molar was smoothed and an appointment made to review the ulcer a week later.

The patient attended for the review appointment today and there has been no

alteration in the appearance of the ulcer.

The patient suffers from hypertension and takes captopril daily. He smokes 20

cigarettes a day and has done for 40 years. He drinks around 20 units of

alcohol a week.

In view of these findings, I believe the ulcer may be associated with oral

carcinoma. I have communicated my concerns to Mr .

Yours sincerely

Dentist BDS

If an urgent referral, such as the one above, is required, the oral surgery

department should be contacted by telephone (as soon as possible) and

informed of your concerns. The hospital can then arrange an urgent

appointment. Some hospital departments might ask you to send the letter by

fax.

More routine referrals (for example: a partially erupted wisdom tooth causing

repeated pericoronitis) follow the same pattern but obviously there is no

need to telephone the hospital. When informing the patient of such a

referral, warn the patient that the waiting time may be lengthy.

If possible, always type your referral letters (but don't forget to sign

them).

Some orthodontists and oral surgery departments use printed referral forms.

These forms request the relevant information and are an efficient way of

communicating information.

Communicating with General Medical Practitioners

You will regularly have to request advice from a patient's doctor (especially

in regard to antibiotic prophylaxis, steroids and warfarin). Always get this

advice in writing. (Note: doctor's surgeries are very busy and often you may

have to 'chase up' a response by called the surgery to inquire whether your

request has been dealt with). Also, do not assume that a doctor will know

what the recommended procedure is when a medically compromised patient needs

dental treatment, so if you receive advice which you know to be incorrect,

question it, and if in doubt seek further advice.

[Guest guest]

THANKS EVER SO MUCH!!From: Vera Lucia <veradentaluk@...>oremuttualsupportgroup < >Sent: Friday, 11 November 2011, 13:18Subject: What to do when referring a patient, better to read now

What to do when referring a patient

Take a new medical history.

Examine the radiographs and clinical findings.

Explain to the patient why you want to refer them and to whom.

Referral letters

The following information is required:

Name, title and address of

person to whom you are referring the patient.

Patient's name, address

and Date of Birth (DOB)

Reason for referral.

The history of the

complaint

Request for advice and/or

treatment.

Any previous relevant

treatment carried out with dates.

Relevant medical/social

history.

Details of enclosures such

as radiographs

Specific referrals require further information:

Orthodontic referrals

Diagnosis

Patient's attitude to

treatment

Oral hygiene

Caries rate

Previous orthodontic

treatment

Radiographs and study

models

Oral surgery referrals

History of complaint

Suggested diagnosis

Indication of urgency

Relevant radiographs

Periodontal Referrals

CPITN Score

Mobility scores

Information on deep or

persistent pockets

Relevant Radiographs

Oral Hygiene History

Example orthodontic referral letter

Mr

Consultant Orthodontist

St 's Hospital

Chelmsford

01/01/04

Re: Miss Jane

10 Main Street

Danbury

CM3 7YR

DOB: 31/01/91

I should like to refer this 12-year-old girl for advice on the management of

her upper canine crowding. She is unhappy about the appearance of her teeth

and is prepared to wear an appliance.

She is a regular attender, and her oral hygiene is good. She is caries free.

All teeth are present on radiograph. She has a 3mm overjet with a complete

overbite.

The lower arch is well aligned. The upper arch has moderate anterior crowding

with insufficient space for the canines, which are erupting buccally.

Would it be reasonable to?

1. Extract upper 4's

2. Fit URA to retract upper 3's?

Jane has asthma and regularly uses a ventolin inhaler.

Thank you for seeing Jane.

Yours sincerely

Dentist BDS

Enclosures: 1 set study models, 1 panoral radiograph

Orthodontic waiting lists are long in some parts of the country, so refer as

soon as the problem becomes apparent and inform the patient that they may

have to wait some months for an appointment with an orthodontist.

Oral Surgery referral letter

Mr White

Consultant Oral Surgeon

St 's Hospital

Chelmsford

01/01/04

Re: Mr

24 Willow Avenue

Bicknacre

CM4 8RT

DOB: 11/06/49

This letter follows our telephone conversation earlier today.

This gentleman presented at the practice last week complaining of a

persistent ulcer on the side of his tongue. He reported that the ulcer has

been present for at least four weeks. It has caused intermittent tenderness.

On examination, the ulcer was located on the left lateral border of the

tongue and was 7mm in diameter. The edge of the ulcer was rolled and hard to

the touch.

Extra orally, there was no detectable enlargement of the sublingual or

submandibular lymph nodes. A sharp cusp from the nearby lower left first

molar was smoothed and an appointment made to review the ulcer a week later.

The patient attended for the review appointment today and there has been no

alteration in the appearance of the ulcer.

The patient suffers from hypertension and takes captopril daily. He smokes 20

cigarettes a day and has done for 40 years. He drinks around 20 units of

alcohol a week.

In view of these findings, I believe the ulcer may be associated with oral

carcinoma. I have communicated my concerns to Mr .

Yours sincerely

Dentist BDS

If an urgent referral, such as the one above, is required, the oral surgery

department should be contacted by telephone (as soon as possible) and

informed of your concerns. The hospital can then arrange an urgent

appointment. Some hospital departments might ask you to send the letter by

fax.

More routine referrals (for example: a partially erupted wisdom tooth causing

repeated pericoronitis) follow the same pattern but obviously there is no

need to telephone the hospital. When informing the patient of such a

referral, warn the patient that the waiting time may be lengthy.

If possible, always type your referral letters (but don't forget to sign

them).

Some orthodontists and oral surgery departments use printed referral forms.

These forms request the relevant information and are an efficient way of

communicating information.

Communicating with General Medical Practitioners

You will regularly have to request advice from a patient's doctor (especially

in regard to antibiotic prophylaxis, steroids and warfarin). Always get this

advice in writing. (Note: doctor's surgeries are very busy and often you may

have to 'chase up' a response by called the surgery to inquire whether your

request has been dealt with). Also, do not assume that a doctor will know

what the recommended procedure is when a medically compromised patient needs

dental treatment, so if you receive advice which you know to be incorrect,

question it, and if in doubt seek further advice.