Specialist services Fig 3a Fig 3b Fig 4a
Legend
Figs 1a &1b: Patient referred for advice regarding continuing pain in the lower right quadrant. Recent restoration on 48. This tooth was TTP and there was also periradicular infection related to 47. 47 had previously been
endodontically treated with a large periradicular area. The posi- tion of 48 was not ideal and prognosis of 47 was poor. The GDP, who had experience in oral surgery, was advised to extract 47 and 48 and carry out curettage of the 47 socket.
Figs 2a to 2d: Patient referred
with problems related to upper anterior bridge. Bridgework extended from 13 to 23 with post-crown retainers; there was peri-radicular infection related to 12 and 13 and extensive caries in 23. The GDP will carry out general care with the specialist carrying out implant-retained
bridgework from 13 to 23.
Figs 3a & 3b: Patient had implants placed in USA in 1993 with no maintenance following treatment, which has resulted in considerable bone loss around some of the implants. He will have treatment to stabilise the peri-implant tissues and reduce
further bone loss around the implants.
Figs 4a & 4b: Patient referred for a fixed restoration in the upper arch. CT scan assessment carried out for implant-retained restorations showed that bone- grafting will be required.
Continued »
cialised equipment such as operating microscopes and cone beam CT scanners to help them carry out assessment and treatment of complicated cases. When considering where to
refer a patient for specialist advice or treatment, it is vital that the dentist has the confi- dence in the specialist and knows they are referring their patients to someone who they
know and trust to carry out first-class treatment for their patients. The specialist should be considered as part of the team and should be able to support the GDP in a number of ways: • To provide diagnostic and treatment planning advice. There will be cases where the GDP is happy to undertake treatment, but requires advice on treatment plan- ning. In such cases, it is often
The referral centre should provide the GDP with a comprehensive referral pack. This should provide the GDP with all the information they require in relation to referral of patients, details of the services provided and also a fee guide
useful for the GDP to attend with their patient on the consultation appointment.
• Assist with part of the treat- ment. There will be other cases where the GDP is happy to carry out most of the treatment but requires assistance with part of the treatment plan, for example
52 Scottish Dental magazine
crown-lengthening surgery, endodontic treatment prior to restoration or orthodontic treatment prior to restora- tive treatment.
• Provide specialist treatment in cases where all of the treat- ment is beyond the scope of the GDP. Examples may be the provision of extensive crown and bridgework, implant treatment or multi- disciplinary treatment.
• Provide opportunities for the referring GDP to visit and discuss cases personally. Most specialists will be very happy for the GDP to visit the centre to discuss planning of cases.
• Communicate regularly and keep the GDP updated with treatment progress. It is important that any GDP who sends a patient to a referral centre is kept fully updated with the progress of their patient’s treatment. At the end of treatment, the patient will be referred back to the GDP for continuing care or there may be situations where shared care may be best for the patient.
• Provide training and teach- ing opportunities for the GDP and their team. Many referral centres will provide seminars, hands-on courses and year courses which will help develop their knowl-
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