Referral Patterns of Pediatric Oral Surgery Cases: A Pilot Survey of United Arab Emirate Dentists.

Heba Allah Madi, Samy Darwish, Mawlood Kowash, Amar Hassan Khamis, Iyad MA Hussein


Objective: To assess the referral patterns of General Dental Practitioners (GDPs) and Pediatric Dentists (PDs) when faced with a range of Pediatric-Oral Surgery (POS) cases. Material and Methods: Eighty-two dentists treating children [51.2% GDPs (n=42) and 48.8% PDs (n=40)] were shown clinical photographs or radiographs of twelve common POS cases. Opinions on whether to “manage it yourself”, “refer to a/another pediatric dentist”, “refer to an oral surgeon (OS)”, “refer to a multidisciplinary clinic (MDC)”, or “do nothing” were sought. Statistical analysis was carried out using SPSS software with Chi-square test (p≤0.05). Results: Both GDPs and PDs reported significantly higher referrals to OS of: 1) lower lip mucoceles (50%, 52.5% respectively), 2) exposure of impacted maxillary canine (64%, 51.3%) and 3) dento-alveolar trauma cases (73.8%, 65%). A majority of GDPs and PDs reported self-managing of: 1) removal of multiple deciduous carious teeth (81%, 97.5%), 2) odontogenic infections with facial swelling (57.1%, 92.5%), 3) removal of ankylosed submerged primary molars (66.7%, 95%) and 4) dental trauma (71.4%, 100%). PDs reported self-managing primary herpetic gingivostomatitis (PHGS, 95%) compared to 45.2% of GDPs. GDP referral of PHGS to the PDs was 42.9%. There were no significant differences between both groups regarding removal of a mesiodens, release of a tongue-tie, a labial frenectomy, or a lip laceration, but the majority would refer to oral surgeons in these cases. Conclusion: Whilst United Arab Emirates dentists sampled referred some pediatric-oral surgery cases to oral surgeons, general dental practitioners were reluctant to refer pediatric-oral surgery cases to pediatric dentists, preferring to self-manage them.


Pediatric Dentistry; Surgery, Oral; Referral and Consultation

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General Dental Council. The first five years. 3.rd. ed. 2008. Available at: [Accessed 1 January 2018].

General Dental Council. Scope of Practice. Available at: [Accessed 30 January 2018].

Council on Clinical Affairs. American Academy of Pediatric Dentistry. Guideline on management considerations for pediatric oral surgery and oral pathology. 2015. Available at: [Accessed 7 January 2018].

NHS England. Chief Dental Officer Team. Guide for Commissioning Oral Surgery and Oral Medicine Specialties. Available at: 12/2015/09/guid-comms-oral.pdf. [Accessed 30 January 2018].

British Society of Periodontology (2016). Referral of patients in: The good practitioner’s guide to periodontology. Available at: [Accessed 30 January 2018].

Ministry of Health. Oral Health Specialist Referral Protocols. Sydney, Australia, 2011. Available at: [Accessed 30 January 2018].

NHS Greater Glasgow. Referral Guidelines to Dental Departments in Glasgow. Available at: [Accessed 7 December 2017].

NHS Birmingham Community. Dental Referrals for Professionals. Available: [Accessed 7 January 2018].

General Dental Council. Specialty Training Curriculum in Oral Surgery. 2014. Available at: February%202014.pdf. [Accessed 30 January 2018].

General Dental Council. Specialty Training Curriculum in Pediatric Dentistry. 2009. Available at: [Accessed 30 January 2018].

Reebye U, Hunter MJ, Cottrell DA. General dentists' referral patterns for oral surgical procedures. Available at: [Accessed 30 January 2018].

Ham C. Money can’t buy you satisfaction. Br Med J 2005; 330(7491):597-9. doi: 10.1136/bmj.330.7491.597.

Pacheco-Vergara MJ, Cartes-Velásquez RA. Referrals, procedures and complications in oral surgery services. Literature review. Rev Odontol Mex 2016; 20(1):e13-e21. doi: 10.1016/j.rodmex.2016.02.002.

Foley J, Soldani F. The use of theatre time for paediatric dentistry under general anaesthesia. Int J Paed Dent 2007; 17(1):29-33. doi: 10.1111/j.1365-263X.2006.00789.x.

Foley J. Paediatric minor oral surgical procedures under inhalation sedation and general anaesthetic: a comparison of variety and duration of treatment. Eur Arch Paed Dent 2008; 9(1):46-50.

Ogden O, Kershaw A, Hussein I. Use of theatre time for dentoalveolar operations under general anaesthesia. Br J Oral Maxill Surg 2000; 38(4):331-4. doi: 10.1054/bjom.2000.0309.

Yates JM, Halai T. Assessment of oral surgery referrals from primary care to a regional dental hospital. Oral Surg 2014; 7(3):168-76. doi: 10.1111/ors.12087.

Dubai Health Authority. Health Regulation Department. Scope of Practice and Core Competencies for General Dentists and Dental Specialists. 2016. Available at: [Accessed 30 January 2018].

Dubai Health Authority. Health Regulation Department. Outpatient Care Facilities. 2012. Available at: [Accessed 30 January 2018].

International Association of Dental Traumatology. The Dental Trauma Guide. Available at: [Accessed 30 January 2018].

Counihan K, Al-Awadhi EA, Butler J. Guidelines for the assessment of the impacted maxillary canine. Dent Update 2013; 40(9):770-7. doi: 10.12968/denu.2013.40.9.770.

Husain J, Burden D, McSherry P. Management of the Palatally Ectopic Maxillary Canine. Royal College of Surgeons of England. 2016. Available at: [Accessed 30 January 2018].

General Dental Council. UK. Standards for the Dental Team. 2013. Available at: [Accessed 30 January 2018].

Madi H, Darwish S, Khamis AH, Hussein I. Referral patterns of paediatric oral surgery cases: A survey of dentists’ opinions. Int J Paediatr Dent 2016; 26(Suppl 1):24. doi: 10.1111/ipd.12247.


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