Dental Services Referral Form - Paediatric Dentistry (Page 4 of 4) in pdf

Criteria Paediatric Dentistry

Appropriate patients

This service is for children and adolescents up to 15-16 years of age dependent on

their development, and manages complex preventive and therapeutic dental

problems.

Care may be offered within two different streams of Paediatric Dentistry clinics

dependant on the reason for referral. For example, General anaesthetic

management of dental problems may be required.

Clinical criteria

Specialist Paediatric Dentistry

please tick criteria

Complex dental pathology requiring specialist management (cysts, MIH)

applicable to this

Special needs (intellectual, physical and sensory disabilities)

patient

Syndromes and other genetic disorders including amelogenesis imperfecta and

dentinogenisis imperfecta)

Medically compromised conditions such as Haemolytic disorders (e.g. Haemophilia,

leukaemia, thrombocytopaenia etc.)

Dental anomalies (supernumerary teeth, dilaceration, odontomes, missing teeth,

ankylosed teeth)

Behaviour management requiring relative analgesia

Interceptive orthodontics, including management of conditions such as dehiscence,

space maintenance, anterior and posterior cross bites, ectopic eruptions or non-

eruption, habits, etc

Early childhood caries that require complex surgical restoration procedures

General Paediatric Dentistry

Behavioural difficluties that may require management under general anaesthesia

More than two attempts by different clinicians should be made to treat the patient

under local anaesthesia before referring a child for a general anaesthetic.

Process for

The referring clinician is to contact RDHM Patient Services on (03) 9341 1000 and

emergency referrals

ascertain the ability of the clinic to coordinate care on the day.

Patients with acute symptoms should clearly mark this Dental Services Referral Form

as urgent, indicating reasons for urgent attention.

The patient must be provided with this completed Dental Services Referral Form and

any available radiographs and directed to proceed to the main hospital reception

after an appointment has been organised. Due to demand, it may not be possible to

provide the care proposed for a particular patient on the same day. This particularly

applies to patients requiring general anaesthesia. However, patients with potential

serious infections (e.g. spreading cellulitis, submandibular abscess) will be seen on

the same day.

Prior phone notification is essential.

Exclusions

If a general anaesthetic is required, patients with Type 1 daibetes, blood dyscrasias

or bleeding disorders or severe respiratory disorders should be referred directly to

the Department of Dentistry at the Royal Children’s Hospital.

Consultation

Patients meeting the referral criteria will be offered a screening consultation to

please ensure your

assess treatment requirements.

patient understands

the following;

Where treatment under General Anaesthesia has been indicated without the

provision of a definitive treatment plan, the child will be referred to an Oral Health

Therapist to attempt treatment under local anaesthesia in the first instance.

Patients assessed as needing procedures under General Anaesthesia will be placed

on the appropriate waiting list.

Waiting times are generally shorter for procedures that can be performed under local

anaesthesia

Click here to return to top -

click

Revised September 2014

Dental Services Referral Form - Paediatric Dentistry Page 4

Related Articles

Related forms

Related Categories