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The decision to treat or refer periodontal patients

Figure 43.1 Making the decision to treat or refer.

Figure 43.2 (a) Guidelines for referral based on complexity scores. (b) Modifying factors relevant to periodontal treatment for application to complexity scores. (c) Medical history that significantly affects clinical management. BPE, Basic Periodontal Examination; GDP, general dental practitioner.

Figure 43.3 Key information to include in a referral letter.

For many patients the management of their periodontal condition can be solely carried out in general practice. However, for some patients referral to a specialist periodontist is appropriate. The treatment may be provided within the specialist referral centre or in combination with treatment in the general practice setting.

The decision to treat or refer a patient will be dependent on three broad issues (Fig. 43.1). Any decision is made on a case-specific basis, however it is useful to have guidelines to help inform that decision. One such set of guidelines (Clinical Effectiveness Committee of the Royal College of Surgeons of England, 2001) is based on using the Basic Periodontal Examination (BPE) (Chapter 17) index and taking into consideration modifying factors or medical factors that could impact on management to determine the complexity of a case (Fig. 43.2).

Role of the specialist periodontist

The specialist periodontist has the following responsibilities:

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