Letters to the Editor

I read with interest the most current issue of Dental Update, especially of interest was how the COVID-19 pandemic and lockdown has affected 2-week wait (2WW) oral cancer referrals.

As a dental core trainee working in an oral and maxillofacial unit, we too have seen a change in our 2WW referrals. During the initial lockdown between March and June 2020, we received 74 2WW referrals in total. Of these, 12 (15%) were from GDPs who had conducted a consultation by telephone because dental practices were forced to close during this time. Following the reopening of general dental practices, over the same length of time, between August and October 2020, we received 126 2WW referrals; 69 (55%) of which were from GDPs. Of these 69, 23% were discharged after their first appointment, and 40% underwent further investigations.

Since the reopening of dental practices, not only has there been an increase in the number of referrals from GDPs, but interestingly, also an increase in the number of inappropriate 2WW referrals. This number was found to be higher compared with previous audits undertaken in the department looking at the appropriateness of 2WW referrals before the pandemic. Examples of inappropriate referral include GDPs using the pathway to refer patients with multiple carious teeth who were in pain and those with a 15-year history of recurrent ulceration and a traumatised mandibular tori.