GP’s Guide to OMFS Referrals
Dental Problems: The 'Dentist First' Approach
For most common dental issues, such as toothache or decay, the most appropriate first point of contact is a general dentist.
It is important to remember that Oral and Maxillofacial Surgeons (OMFS) primarily provide surgical solutions. For a patient with a salvageable tooth, our main treatment option is surgical extraction. A general dentist, however, has a wider range of tooth-preserving treatments available.
Refer to a General Dentist for:
Standard toothaches
Dental decay requiring fillings
Broken or chipped teeth
Root canal treatment
By referring to a dentist first, you give your patient the best chance of preserving their natural teeth and exploring all non-surgical treatment avenues.
Surgical Cases: Direct Referral to an OMFS
Certain conditions have a clear surgical pathway, and a direct referral to an OMFS is the most efficient route for the patient.
Impacted & Problematic Wisdom Teeth
The most common example is symptomatic wisdom teeth. These teeth are rarely offered restorative treatments like fillings or root canals. When they cause pain, infection, or damage to adjacent teeth, the definitive treatment is surgical removal.
Mandatory Imaging: OPG X-ray
To accept a referral for wisdom teeth assessment, we require a recent Orthopantomogram (OPG) x-ray.
An OPG is essential for us to visualise:
The position and orientation of the wisdom teeth.
The anatomy of the roots.
The relationship of the teeth to vital structures, such as the inferior alveolar nerve.
A Guide to Referring Oral Lesions
Oral lesions can be broadly divided into two categories with different referral pathways.
Category 1: 'Lumps and Bumps' – Refer to OMFS
These are discrete physical lesions that require surgical intervention, either for diagnosis (biopsy) or complete removal (excision).
Examples include:
Fibrous lumps (e.g., irritation fibroma)
Mucous cysts (mucoceles)
Any suspicious growth or ulcer requiring tissue diagnosis
Action: Please refer these patients directly to an OMFS for surgical assessment and management.
Category 2: Blistering Lesions & Coloured Spots – Refer to an Oral Medicine Specialist
This category includes lesions that appear as blisters, ulcers, or patches of discolouration (white, red, or other colours). These are often manifestations of a systemic or mucocutaneous condition.
These conditions include:
Oral Lichen Planus
Pemphigus Vulgaris
Mucous Membrane Pemphigoid
These conditions are typically managed medically with topical or systemic therapies, not surgery. The appropriate specialist for ongoing care is an Oral Medicine Specialist.
Our Collaborative Role with Oral Medicine
We frequently work in conjunction with our Oral Medicine colleagues. A patient may be referred to us by an Oral Medicine Specialist specifically for an incisional biopsy to confirm a diagnosis. However, once the diagnosis is established, the patient will return to the Oral Medicine Specialist for long-term medical management and follow-up.
