title: The appropriateness of referral of medically compromised dental patients to hospital.
abstract: Hospital departments of oral and maxillofacial surgery make a substantial contribution to both managing and treating medically-compromised dental patients. Contracting arrangements should take account of this. Demographic data suggest that the treatment of medically-compromised elderly dentate patients will become increasingly important in the General Dental Service (GDS). To determine the medical conditions and treatment requirements prompting referral of these patients to hospital, a prospective study was undertaken of 75 consecutive adults referred for hospital treatment specifically because of a medical condition which prevented delivery of routine dental care in the GDS. Patients (mean age: 56 years) were referred mainly from general medical (33%) and dental (62%) practitioners. Cardiovascular disease was the most frequently cited medical condition requiring referral (43%; n = 32 cases). Forty-eight patients (64%) were symptomatic on presentation and on average had attended on 2.3 occasions before definitive treatment was instituted. Fifty-two patients (70%) had no special treatment requirements other than those available in the GDS, 11 patients (15%) simply required antibiotic prophylaxis and 81% were treated by undergraduates or junior staff. These data suggest that many patients referred for dental hospital treatment because of underlying medical condition are not in fact medically-compromised and may be treated in the primary care setting.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Dental Hospital, UWCM, Cardiff, Wales, UK.
authors.forename: E G
authors.initials: EG
authors.lastname: Absi
authors.forename: J
authors.initials: J
authors.lastname: Satterthwaite
authors.forename: J P
authors.initials: JP
authors.lastname: Shepherd
authors.forename: D W
authors.initials: DW
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D019072:Antibiotic Prophylaxis; D000925:Anticoagulants / Q000627:therapeutic use; D003284:Contract Services; D016854:Dental Anxiety / Q000150:complications; D016321:Dental Care for Aged; D017742:Dental Care for Chronically Ill; D003796:Dental Service, Hospital; D003798:Dental Staff, Hospital; D005194:Family Practice; D005260:Female; D005792:General Practice, Dental; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012017:Referral and Consultation; D013335:Students, Dental
chemical_list: D000925:Anticoagulants