GPs, dentists, nurses, care workers, pharmacists, and many others1 are at the forefront of primary care. Despite differences in working conditions and the effects of organisational pressures, I believe all of these health professionals do what they can to look after their patients’ best interests by collaborating and use of effective communication.
However, I have noticed that communication between GPs and their dental counterparts can leave a lot to be desired. Some patients find it difficult to get a dental appointment (or have dental phobia!) and may attend their GP instead. This may lead to delay in dental diagnosis and treatment as well as wasted GP time.
Occasionally, however, there are some patients whose diagnoses fall beyond the scope of the general dental practitioner (GDP) and may require treatment from a specialist in oral and maxillofacial surgery or oral medicine. For example, these patients may be complaining of chronic pain from their lower jaw which could be as simple as toothache or as complicated as trigeminal neuralgia; or they may have an extra-oral swelling that could be a dental abscess2 or as severe as a malignancy or ischaemic cardiovascular disease.
While a dentist could manage some of the above cases, when urgent care is required (as for tracking dental abscesses or squamous cell carcinoma), there should be easy access to an appropriate treatment pathway3 from their initial contact with a health professional, that is, their GP or GDP. Whatever the origin of the referral, the speed and appropriateness is what matters.
GPs should not be expected to know every treatment modality for toothache; an appreciation of the most common causes and diagnoses of pain in the mouth will indicate any outliers and allow for prompter referral. Dentists contact local GP practices for up-to-date lists of medication, and would be more than happy to offer an opinion or advice, so we can continue to provide the highest quality of patient care. With increasingly complex management of patients,4 dental interception and preventative care are more crucial than ever.
- © British Journal of General Practice 2015
