Referring to the on-call oral and maxillofacial surgery team – what, when and how to refer emergency conditions

Clinicians have an ethical and legal obligation to communicate effectively with members of the wider team with whom they work. The primary care clinician is occasionally faced with conditions which cannot be managed in a primary care setting and require referral to the on-call OMFS team.¹ This paper describes the conditions which require referral to a secondary care setting and provides a referral proforma at the end which clinicians can consult at the time of referral.

For patients who seek care for post-operative discomfort, a thorough history will direct the clinician toward the source of pain. Prolonged pain following extraction should prompt the clinician toward considering a retained root fragment, dry socket, pulpal/peri-apical pathology from adjacent/opposing teeth, osteomyelitis (particularly in immunocompromised patients), infection, or fracture of the alveolar segment. Exposure of root dentine on the distal aspect of mandibular second molars following lower third molar (L3M) removal can result in dentine hypersensitivity.