Season’s greetings

With an upsurge in dental problems being taken to GPs as Christmas approaches, Leo Briggs explores how to handle patients referred by their doctor

Over the Christmas period, an increasing number of patients visit their family GP with toothache, abscesses and other dental problems.

According to figures published by the British Medical Association (BMA), this applies to 380,000 patients, who should be seeking a dental professional instead. While the study revealed a number of contributing factors, the British Dental Association (BDA) asserts that the trend is caused by dental charges and argues that doctors are ‘unequipped to provide dental treatment’.

From a legal perspective, the Dentists Act 1984 restricts the practice of dentistry to registered dental professionals and those in training.

This means that, unless dually-qualified and appropriately registered with the General Dental Council (GDC), GPs are not supposed to treat dental conditions. They may provide urgent and necessary medical treatment if the patient is not able to contact a dentist, but must be cautious. The GP should be aware of the limits of their competence and consider the availability of other options for care.

What can dentists do?

The GDC expects dental professionals to provide patients with clear information about their arrangements for emergency care.

Dental practices often choose to communicate their out-of-hours arrangements via their website and on a noticeboard in the waiting room.

It is important to regularly check that this information is accurate and up-to-date, especially if the practice is closed for longer than normal over the holiday period.

Another good idea is to have emergency contact details provided on an answerphone message for patients who call outside normal hours.

This is particularly important for patients who are in the middle of more complex and expensive treatment plans.

Such patients generally need information about the arrangements for out-of-hours emergencies before they leave the surgery, alongside appropriate advice about aftercare.

A dental practice, particularly if it provides emergency dental services, may consider contacting local GP surgeries so they know how and where to direct patients in need.

This is supported by the guidance on patients presenting with dental problems by the BMA. It recommends that GPs and practice managers are ‘aware of in-hours and out-of-hours dental services available locally to manage urgent and emergency dental conditions’.

The BMA explains that this can include NHS Choices, NHS 111, local dental access centres and local NHS dentists.

Helping in an emergency

It’s also crucial to consider how to approach a patient who attends your practice for emergency treatment after being sent by their GP. In the DDU’s experience, there could be a number of factors that make these consultations more challenging, such as:

If the patient is attending for the first time, they will be unfamiliar with you and your practice

They could expect treatment that you don’t believe is in their best interests, such as extracting a problem tooth

They may be anxious and in pain, which generally means there is a greater risk of misunderstandings and they may be less tolerant of perceived service failures.

It is helpful if the patient has been given accurate information about the nature and limitations of any emergency care you can provide. Therefore, it is good to try and ensure that when someone is directing patients to you, they know what patients can expect and can convey this information accurately.

Hopefully, we can tackle this issue head-on and ensure that patients are receiving the safest and best treatment for their emergency dental issues, especially over the holidays.


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