Multidisciplinary care

The rest of the hospital is part of your dental treatment.

Dentistry is not separate from the rest of medicine, and for a lot of patients that is not a detail. It decides what can safely be done, in what order, and with whom in the room.

A standalone clinic manages this by sending you out and waiting. You take a letter to a physician, wait for an appointment, wait for a reply, and come back. Treatment that should take a fortnight takes months, and a proportion of patients simply stop coming.

Inside a hospital, that whole loop is a conversation between two departments in the same building.

The referral is a corridor, not a letter.

Working with

Ten departments, and what each one changes about your dentistry.

Cardiology

Extractions and surgery for patients on blood thinners, and for hearts that need clearing first.

Cardiology: before your visit

Have you had an angiogram, an angioplasty or a stent?
Do you take a blood thinner, such as aspirin, clopidogrel or warfarin?
Any heart attack, bypass or valve surgery?
Do you have a pacemaker?

Diabetology

Implants, gum treatment and healing that depend on blood sugar being under control.

Diabetology: before your visit

Do you have diabetes?
Is it treated with tablets or insulin?
What was your last sugar or HbA1c reading?
Do cuts and wounds heal slowly for you?

Gynaecology

Dental treatment during pregnancy, planned with the obstetric team rather than postponed.

Gynaecology: before your visit

Are you pregnant, or could you be?
If so, how many weeks?
Are you breastfeeding?
Any complications in this pregnancy?

Neurology

Facial pain and nerve conditions that need a neurologist before a dentist.

Neurology: before your visit

Do you have facial pain, burning or shock-like pain?
Any numbness in your face, lips or tongue?
Have you had a stroke, fits or epilepsy?
Do you take medicine for nerves or seizures?

Nephrology

Safe dentistry for patients on dialysis, where drug doses and timing both change.

Nephrology: before your visit

Do you have kidney disease?
Are you on dialysis? On which days?
Have you had a kidney transplant?

Urology

Shared care where medication, stones or infection touch both departments.

Urology: before your visit

Are you being treated for kidney stones or a urine infection?
Are you taking antibiotics now?
Do you take prostate or bladder medicines?

Oncology

Dental clearance before radiotherapy and chemotherapy, and care of the mouth during it.

Oncology: before your visit

Have you had radiotherapy to the head or neck, or is it planned?
Are you on chemotherapy?
Have you had bone-strengthening injections or tablets?

General medicine

The physician who reviews the whole patient before a long procedure begins.

General medicine: before your visit

Do you have high blood pressure, thyroid trouble or asthma?
Which medicines do you take every day?
Are you allergic to any medicine?

Anaesthesiology

Full-mouth work in one sitting, for patients who cannot be treated awake.

Anaesthesiology: before your visit

Have you had general anaesthesia or sedation before?
Did you react badly to it?
Do you snore heavily or have sleep apnoea?

And the rest of the hospital

General surgery, orthopaedics, ENT and every other department in the building.

And the rest of the hospital: before your visit

Any surgery or hospital stay in the last year?
A joint replacement in the last two years?
Any other long-term condition?

If you are being treated for something else, say so first.

When you book, say what you are being treated for and what you take. It is the single most useful thing you can do, and it is often what decides whether your appointment goes ahead on the day.

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