How to refer to the Dental Department

• Cardiac patients meeting one or more of:
  • Significant ventricular dysfunction on treatment
  • Significant pulmonary hypertension on treatment
  • Uncorrected cyanotic heart disease. Significant outflow tract obtrusion e.g. HOCM, aortic stenosis
  • Symptomatic or high risk Arrhythmias e.g. long QT
  • ‘Single’ ventricle physiology
  • On anticoagulants that cannot be safely stopped
    
• Metabolic patients meeting one or more of:
  • Mucopolysacchaidosis.
  • Special considerations for starving e.g. hyperinsulinism, MCADD.

Diabetic patients should be managed elsewhere.

• Haematology/Oncology Patients
  • Bleeding diatheses, anticoagulated

BMT/Oncology patients undergoing active management (i.e. not well long term follow up’s).

• Neurology Patients
  • Poorly controlled epilepsy.
  • Neurological and neuromuscular disorders impacting on respiratory function. (e.g. multiple severe chest infections)
  • Duchenne Muscular dystrophy.
  • Myasthenia gravis.
  • Complex osteogenesis imperfecta
    
• Transplant patients/Renal
  • Solid organ transplant recipients and end stage renal failure patients.
    
• Technology dependent children
  • Patients requiring CPAP/BIPAP, TPN or dialysis.
    
• Rare anaesthetic considerations
  • Young patients with difficult airway problems.

Note malignant hyperthermia should be managed elsewhere.

Rare medical conditions

Other cases will need to be discussed on a case by case basis with the Chief of Service for Sight and Sound

Some local services are able to manage patients with conditions listed above and there is no intention to discourage this.

As part of commissioned service, the team accept referrals from the below internal teams. These referrals must be completed on EPIC.

• Cleft
• Craniofacial
• EB