Dental and Medical Specialist Referral Services
The specialist clinicians at the BDC are formally certified university graduated practitioners in their respective areas of expertise. Their combined experience encompasses knowledge and training in the entire range of dental treatments
Resources for Prosthodontic, Implant and Periodontal Referrals
Resources for Medical Practitioner Referrals
Reasons for recommending a prosthodontic referral for your patients
Prosthodontists bring both the necessary experience and expertise in the treatment planning and delivery of care for your patients who present with complex and difficult to manage oral conditions.
Prosthodontists training is fundamental in managing patient requirements in situations that involve consideration in the 8 areas outlined below.
Complex Implant Supported Restorations
Patients with significant restorative problems may require extensive multiphase rehabilitation. This may include managed phased extraction of teeth, the surgical placement of implants and the fabrication of implant supported crowns bridges or a complete arch prosthesis.
In complex presentations these constructions may need to be fabricated initially on a provisional basis. Subsequent choice of an appropriate final restoration from the design and material selection perspectives can be decided based on the patient’s response to initial treatments and their preferences.
The Prosthodontist can determine the appropriate restoration for your patient to restore both function and appearance from a wide range of design and material options.
Challenging Edentulous Cases
Providing conventional or implant supported dentures for edentulous patients with severely resorbed ridges vertical dimension discrepancies and significant interarch deficiency can be difficult.
Removable Partial Denture Services
Where other treatment options are not feasible or a patient expresses a preference for a removable partial denture solution to address appearance and functional issues Prosthodontists can offer particular assistance.
The combination of removable partial denture design solutions supported by crowns and precision attachments can deliver an enhanced treatment outcome for the patient. Such combinations cases can eliminate the visibility of unsightly clasp arrangements and provide enhanced retention and support for a removable partial denture solution.
Prosthodontists provide the necessary diagnostic and design expertise combined with an intricate knowledge of the sequential clinical and laboratory phases in delivery of a complex removable denture solutions designed to meet patient requirements.
Frequently now, incorporating implant and tooth supported removable partial denture solutions is another option to the design portfolio for these cases.
Comprehensive Reconstructive Dentistry
Management of cases with severe functional defects resulting from trauma cancer surgery or developmental defect such as cleft palate or craniofacial anomalies. These clinical presentations frequently require treatment approaches with built in contingencies that anticipate future treatment requirements over the lifetime of the proposed restorations.
Avoiding compromises in function, chewing swallowing and speech, as well as appearance, may require a significant amount of planning between the various team members
Where there has been considerable loss of both had and soft tissue Prosthodontists possess the special skills for replacement of maxillofacial structures with the necessary expert laboratory support from design and fabrication perspectives.
Re-treatments, Management and Restoration of Compromised or Failing Dentitions
Prosthodontists provide expertise in diagnostics and treatment planning for dealing with breakdown of existing dental treatments, which may involve failing or damaged complex restorations.
Evaluation of extensively restored dentitions with damaged restorations with compromised supporting structures, benefit from diagnostic and treatment planning skills. Retreatment scenarios can provide specific challenges in terms of the overall predictability of the outcome.
The Prosthodontist is uniquely positioned to provide a management approach to the deliver of care for this type of patient. Consideration involves accurate diagnosis, treatment planning options, risk identification and designing the sequencing and scheduling of treatment delivery. This caseload comprises a significant percentage of prosthodontic referrals.
Bruxism, Erosion and The Severely Worn Dentition
Treatment of dentate patients with extremely worn teeth, deep vertical overlap and a history of bruxism, erosion, clenching and TMJ disorders all present difficult and time-consuming management scenarios.
These complex clinical presentations with significant tooth surface loss both in the partially edentulous and fully dentate patient require in-depth diagnosis with the necessary laboratory work up at the planning and design phase prior to embarking on sequenced treatment.
Multiple treatment sessions and periods of Provisionalisation with interim restoration may be required to provide predictable outcomes.
Intricate Esthetic Procedures
Meeting patient esthetic requirements can be a critical aspect of any restoration whether it is a single crown or veneer to a fixed bridge either tooth or implant supported.
High esthetic patient demands, often where there are limiting functional variables, can be both time- consuming and problematic. Clear understanding of the possibilities and limitations of the treatment options to be employed can make for a more predictable outcome.
Prosthodontists have specific expertise in evaluating and judging the appropriate restoration and materials selection for the management of multiple treatment scenarios in these high-touch esthetically demanding patients.
Treatment requiring several specialists
Patients who require extensive rehabilitation may involve care from multiple medical disciplines often present unique time consuming and scheduling challenges for general dentists. Patients often present with specific medical conditions, which may require modifications to treatment planning scenarios.
Prosthodontists are trained to manage and appropriately sequence treatment need for this patient group.
When treatment is complete the patient returns to the referring general practitioner for continued care and maintenance.
Guidelines for Periodontal Referral (American Academy of Periodontology)
The following Guidelines are provided to assist in the timely identification of patients who would benefit from co-management and the unique partnership between a periodontist and referring dentist.
(An explanation of terms is included as part of these Guidelines, and research supporting the content of the Guidelines is available on the American Academy of Periodontology’s Web site at http://www.perio. org.)
The objective is to encourage referring dentists and periodontists to work together to optimise the health of patients. Determining if and when a patient should be referred to a periodontist are sometimes difficult issues.
These Guidelines are intended to help the general practitioner in the rapid identification of those patients at greater risk for the consequences of periodontal inflammation and infection and, therefore, those patients most appropriate for specialty referral.
They are presented in order of severity 3-2-1, category 3 patients being the most severe.
LEVEL 3: PATIENTS WHO SHOULD BE TREATED BY A PERIODONTIST
Any patient with:
Severe chronic periodontitis Furcation involvement Vertical/angular bony defect(s) Aggressive periodontitis (formerly known as juvenile, early-onset, or rapidly progressive periodontitis) Periodontal abscess and other acute periodontal conditions Significant root surface exposure and/or pro-Aggressive gingival recession Peri-implant disease
Any patient with periodontal diseases, regardless of severity, whom the referring dentist prefers not to treat.
LEVEL 2: PATIENTS WHO WOULD LIKELY BENEFIT FROM COMANAGEMENT BY THE REFERRING DENTIST AND THE PERIODONTIST
Any patient with periodontitis who demonstrates at reevaluation or any dental examination one or more of the following risk factors/indicators* known to contribute to the progression of periodontal diseases:
Periodontal Risk Factors/Indicators
Early onset of periodontal diseases (prior to the age of 35 years)
Unresolved inflammation at any site (e.g., bleeding upon probing, pus, and/or redness)
* It should be noted that a combination of two or more of these risk factors/ indicators may make even slight to moderate periodontitis particularly difficult to manage (e.g., a patient under 35 years of age who smokes).
Pocket depths ‡ 5 mm Vertical bone defects Radiographic evidence of progressive bone loss Progressive tooth mobility Progressive attachment loss Anatomic gingival deformities Exposed root surfaces A deteriorating risk profile
Medical or Behavioral Risk Factors/Indicators
Smoking/tobacco use Diabetes Osteoporosis/osteopenia Drug-induced gingival conditions (e.g., phenytoins, calcium channel blockers, immunosuppressants, and long-term systemic steroids) Compromised immune system, either acquired or drug induced A deteriorating risk profile
LEVEL 1: PATIENTS WHO MAY BENEFIT FROM CO-MANAGEMENT BY THE REFERRING DENTIST AND THE PERIODONTIST
Any patient with periodontal inflammation/infection and the following systemic conditions:
Diabetes Pregnancy Cardiovascular disease Chronic respiratory disease
Any patient who is a candidate for the following therapies who might be exposed to risk from periodontal infection, including but not limited to the following treatments:
Resources for Medical Practitioner Referrals
At the Beacon Dental Clinic, we offer a range of specialties including Oral Surgery, Periodontology Restorative Dentistry and Dental Sleep Medicine to provide immediate treatment requirements for patients.
We provide evaluation of tooth and jaw problems, facial swellings, tongue/oral ulcerations and a range of salivary gland problems (dry mouth, burning mouth).
As a hospital affiliated dental specialist group we provide outpatient Clinic based and inpatient/daycare GA Hospital based services.
Conditions we Treat
View a comprehensive list of treatments we provide.
Sleep Apnoea, Sleep Medicine referrals for oral appliance therapy.
Our established Dental Sleep Medicine Clinic receives referrals from physician and surgical colleagues from all the major sleep medicine centers. We are a leading center providing a broad range of oral appliance solutions for patients referred following a medical diagnosis of their particular sleep disorder including Sleep Apnoea, Snoring and Sleep Bruxism (excessive tooth grinding).
Beacon Dental Sleep Medicine Clinic is based in the Beacon Dental Clinic, Beacon Consultants Clinic, Dublin, D18 E7P4, Ireland
Tel: +353 01 5310088| Fax: +353 1 213 5645 | Email: firstname.lastname@example.org