Abstract
We evaluated the quality of general dental practitioner (GDP) tooth wear (TW) referrals to secondary care services in Kent, Surrey and Sussex.Prospective consecutive referrals received via an electronic pathway were assessed from 1 June to 30 October 2019. Reasons for referral, patient demographics, quality of referral, opinion of the triaging clinician and outcome were assessed.Of 671 referrals, 32% were for TW. Males were referred more commonly (1.7:1.0). The median age was 52. Patients were more likely to be referred from distant locations than places closer to the referral centre (p<0.001). Only 55% of referrals suggested a cause for the TW, 33% provided a clinical photograph and 1% recorded a tooth wear index of any type. Referring clinicians most commonly cited attrition as reason for referral (p<0.001). Those under 40 years were referred for erosion (p=0.001) and those over 40 years, attrition (p=0.019). The triaging clinician was more likely to allocate a tooth wear score of three for those under 40 years and a score of four for over 40 years (p<0.001). 47% of referrals were rejected. Males and referrals with photographs were more likely to be accepted for treatment (p=0.017 and p<0.001, respectively).There is a high demand for specialist TW services. The number of referrals being rejected has not changed using the electronic referral system. We advocate the inclusion of mandatory fields for completion by GDPs as well as compulsory clinical photographs and tooth wear indices (Smith and Knight Tooth Wear Index or a basic erosive wear examination - BEWE index).
Highlights
Tooth wear (TW) is defined as surface loss of dental hard tissues from causes other than dental caries, trauma or developmental disorders.[1]
Supporting information sent by referring general dental practitioner (GDP) was reviewed for inclusion of photographs, radiographs, tooth wear index, suspected cause and level of tooth wear
This study is the first of its kind to report on electronic TW referrals in the UK
Summary
Tooth wear (TW) is defined as surface loss of dental hard tissues from causes other than dental caries, trauma or developmental disorders.[1]. TW is pathological when the severity of signs or symptoms are disproportionate for the patient’s age.
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