Referral of the periodontal patient to the periodontist

Main Non-Clinical Factors Influencing Endodontic Referral

Specialisation in endodontics allows for endodontic referrals by general dental practitioner (GDPs) and the study of factors influencing referral. These centre on a triad consisting of the referral process, non-clinical and clinical reasons for referral. Many non-clinical factors have been identified which may influence the referral process to the endodontist. A systematic review study was undertaken into the main non-clinical factors influencing endodontic referral by general dental practitioners to endodontists. Such awareness and appreciation of these factors benefits the commercial aspect of the referral practice, increases access by reducing barriers to care, and ultimately improves patient care. A literature search yielded three papers that met the eligibility criteria. All studies included were cross sectional survey studies completed by GDPs. The main non-clinical factors seen from the studies include: Availability. Personality, relationships and communication.

LOCATION

Availability presented as a common thread throughout all the studies. In conclusion, endodontic referral is multifactorial and influenced by several factors, that are not related to the nature of the endodontic disease, and this is a dynamic process. Due to the lack of high level studies, and limitations of the available studies, further research is suggested into the relevant area of non-clinical endodontic factors for endodontic referral and thus allowing for further analysis.

An Audit of the Quality and Content of Periodontal Referrals and the Effect of Implementing Referral Criteria

Aims

This audit aimed to assess the effect of implementing referral criteria on the quality and content of referral letters sent by general dental practitioners (GDPs) to the periodontal department of a teaching hospital.

Methods

Retrospective data were collected from a total of 450 referrals made in: (i) 1997, prior to any changes; (ii) 2000/2001, after referral guidelines were implemented; and (iii) 2004/2005, after referral criteria were redefined and circulated via Primary Care Trusts. A standardised data-collection form was used to record the information that was provided in the referral letters. This information was also compared to the findings at initial hospital consultations.

Results

There was a small improvement in the administrative details provided in the referral communications in 2000/2001 and 2004/2005. Medical history was often incomplete and was mentioned in 31–34% of referral letters. Use of the Basic Periodontal Examination (BPE) score increased from 17% (1997) to 57% (2004/2005). The information on clinical details otherwise increased in 2000/2001 with a tendency to decrease in 2004/2005. There was little agreement between the clinical details in the referral communications and the findings at consultation in the periodontal department.

Conclusions

Following implementation of referral criteria, there was an increase in the clinical details provided in referral letters. However, the validity of the information provided by the GDPs was often questionable. The number of referrals that provided medical history details remained unchanged. Use of a pro forma was not associated with an improvement in the quality of referrals in this audit.

Demographic Variables Affecting Patient Referrals From General Practice Dentists to Periodontists

BACKGROUND

Within dentistry, a limited body of literature exists regarding the referral relationships between general practitioners (GPs) and specialists. The purpose of this study was to investigate the referral relationship between GPs and periodontists within the state of Virginia.

METHODS

A survey was developed that focused on the demographic variables in the referral relationship between GPs and periodontists. The survey was mailed to 800 dentists throughout the state of Virginia. Descriptive statistics were completed along with multivariate logistic regression analysis comparing the responses with the number of patients referred per month to periodontists.

RESULTS

Female respondents were more likely to refer three or more patients per month to a periodontist than a male respondent (P<0.02). Those dentists who practiced with one other dentist were twice as likely to refer more frequently when compared to solo practitioners or larger group practices (P<0.03). Dentists employing two hygienists were more likely to refer patients than those with fewer hygienists (P<0.02). Those whose practices were >5 miles from the nearest periodontist were more likely to refer patients compared to dentists geographically closer to a periodontist (P<0.02). No other variables had a significant effect on the referral of more patients per month to a periodontist.

CONCLUSIONS

This study indicates that four demographic variables have a statistical influence on the number of referrals per month from a GP to a periodontist. These variables are as follows: female gender, practicing with one other dentist, employing two or more hygienists, and being >5 miles away from the nearest periodontist.