The determination that a case should be referred rather than treated forms part of competent practice, and the categories in which we routinely do so are worth stating explicitly.
Cases outside the scope of the practice
Orthognathic surgery, management of significant maxillofacial pathology, and treatment of temporomandibular disorders requiring multidisciplinary management including pain medicine and physiotherapy.
Paediatric treatment requiring behavioural management, and cases where obstructive sleep apnoea is suspected, which require medical diagnosis prior to any dental appliance therapy.
Cases requiring local continuity of care
Active periodontal disease requiring repeated intervention over months, and patients whose medical status requires close coordination with a treating physician.
In both, the clinical requirement for frequent review over an extended period is incompatible with treatment delivered during a limited visit.
Cases where the requested treatment is not indicated
Requests for restorative treatment of sound teeth in the absence of functional or pathological indication, and requests where the aesthetic objective could not be achieved without disproportionate biological cost.
The appropriate response is explanation of the reasoning and, where an acceptable alternative exists, its proposal.
Cases where travel is not economically justified
Single-unit treatment, where the differential does not offset travel costs. This is communicated as a matter of routine, notwithstanding that it declines the case.
A practice that accepts every enquiry is not exercising selection. The referral rate is a more informative indicator of clinical judgement than the acceptance rate.
To determine whether this procedure is indicated in your particular case, we invite you to request a clinical assessment.
