Minor Oral Surgery Service Referral Guidelines for Lancashire



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NHS Lancashire

Minor Oral Surgery Case Allocation

Introduction


The purpose of this document is to describe proposed allocation criteria for patients who are to be referred for minor oral surgical procedures in Lancashire. These criteria were developed in Blackburn with Darwen and East Lancashire. This is based on a paper compiled by a small group which included the Dental Clinical Lead from NHS Blackburn with Darwen, the Dental Practice Advisor from NHS East Lancashire and the Consultant in Dental Public Health for NHS Blackburn with Darwen and NHS East Lancashire

Rationale for allocation criteria


The following national guidance and other documents were taken into account when assigning criteria for allocation of referrals:

A Curriculum for UK Dental Foundation Training, Department of Health/ Committee for Postgraduate Deans and Director 2006

Foundation Programme Training Guidance for the Appointment of Dentists with Special Interests (DwSIs) in Minor Oral Surgery, Department of Health /Dental and Optical Services Division/FGDP (UK) 2006

Review of Oral Surgery Services and Training, Dental Programme Board Medical Education England 2010

Case mix model, BDA 2010

It is accepted that referrals will be made in accordance with locally agreed criteria (see Referral Guidance document)

Allocation criteria were assigned following consideration of three specific issues these being surgical difficulty, patient’s medical status and level of anxiety.

Allocation criteria relating to surgical difficulty


Table One details allocation criteria for procedure-related types and subtypes. Each procedure related sub-type is allocated to one of three groups (y=yes). These are shown below:

Group 1

Primary care to include provision by NHS Dental Providers

Group 2

Tier 2 Minor Oral Surgery Service

Group 3

Secondary care Oral and Maxillofacial Surgery Service





Anticipated procedure type


Sub-type

Suggested appropriate service

 


GROUP 1

Primary care dental practitioner



GROUP 2

Tier 2 Oral Surgery Service



GROUP 3

Secondary care Oral and Maxillofacial Surgery Service



Procedures involving oral soft or hard tissue likely to compromise major nerves

All procedures







y

Simple extraction of teeth

 All procedures

y







Surgical removal of tooth/teeth or root/s likely to :

 


Involve soft tissue only

y







Involve bone removal

y







Close (within 2mm indicated on radiograph) to maxillary antrum




y




Involve access to the maxillary antrum







y

Involve a non-buccal approach







y

Enucleation of cyst of jaws










y

Surgical removal of impacted wisdom tooth likely to:

Involve soft tissue only

y







Involve bone removal




y




Involve tooth or root division




y




Involve a non-buccal approach







y

Apicectomy of tooth

 


Single-rooted anterior teeth fulfilling referral criteria




y







Multi-rooted teeth or posterior teeth fulfilling referral criteria







y
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