Assessment of oral surgery referrals from primary care to a regional dental hospital

Abstract

Abstract Aim The aim of this study is to evaluate the oral surgery referrals from primary to secondary care, treatment outcomes and appropriateness of referrals. Analysis of the patients referred also enabled assessment of the suitability of teaching provided to dental undergraduates at the University of Manchester. Materials and methods Retrospective analysis of a randomised sample of 300 new patient oral surgery referrals to a university dental hospital. Results The age range of patients referred was 17–85 years (median 51 years) and 58% were women. The vast majority (97%) of referrals was from general dental practitioners (GDPs). Twenty different reasons were recorded for referral, with the most common being anticipation of surgical extraction. A significant proportion of treatment was undertaken without complications using local anaesthesia (50%), with 27% and 9% requiring sedation and general anaesthesia, respectively. Eight per cent of patients did not require treatment, whereas 5% were placed under review or referred elsewhere. Fifty‐three per cent of patients reported a medical problem or condition, of which asthma was the most common (14% of all patients). Furthermore, 51% of patients reported taking medication, most frequently salbutamol (12.7% of all patients). Thirty‐four per cent of referrals were considered inappropriate. Conclusion There was a relatively high rate of inappropriate referrals to secondary care. Increased understanding by GDPs of case complexity, and surgical and medical prognostic indicators could enable more patients to undergo treatment in primary care. The surgical difficulty and medical conditions of the patients evaluated appeared to be addressed in undergraduate teaching, but supplementary targeted training to GDPs may help further reduce numbers of referrals.

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