- Oncology patients - intraoral cancer resections, obturators and post-radiotherapy management.
- Developmental defects - cleft lip and palate, hypodontia, joint orthognathic and/or orthodontic cases and amelogenesis/dentinogenesis imperfecta cases.
- Trauma - severe trauma involving the dentoalveolar complex.
- Medically compromised - e.g. haemophilia, immunocompromised, organ transplant, infective endocarditis and those requiring intravenous antibiotic cover. (We do not provide care for those patients requiring routine oral antibiotic cover).
Please note that a patient currently taking Warfarin does not require dental treatment in hospital unless their INR exceeds 4.0
A comprehensive treatment planning consultation advisory service is available. A limited treatment service is available for patients in list covered in general categories.
Patients with the following conditions are accepted for care.
Conditions of acceptance for specialist periodontal treatment:
- The referring practitioner will manage all other treatment required
- Patients cannot be accepted simply because they will not pay NHS charges in the General Dental Service, or private charges if applicable
High susceptibility to periodontitis based on
- Age of onset
- Age at diagnosis
- Disease severity
- Disease extent
Medical complications or drug interactions affecting periodontal disease or its treatment
Patients with complex problems such as:
- Severe localized gingival recession
- Lack of attached gingival attachment leading to complication
- Gingival overgrowth
Requests for advice
Consultant opinions and advice on treatment planning will be offered for
patients referred with the following documentation:
- Full medical history
- Comprehensive periodontal charting
- Appropriate diagnostic radiographs.
Acceptance of other patients for treatment
If patients referred for opinions have problems which require consultant-led management, or if there are sufficient facilities for treating them on teaching clinics, they may be offered treatment in the department. Practitioners should
advise at referral whether they would like this option if available, subject to resources.
Patients are seen for diagnosis and advice. They are only accepted for treatment if they fall within categories listed under general categories or have had several previous unsuccessful attempts to construct dentures.
Crowns and bridges
A full diagnostic and advisory service is available. We are unable to accept patients for rectification of problems with crown and bridgework that has been carried out outside GKT Dental Institute. We are pleased to advise as to appropriate methods of removal and management of fixed restorations. Patients in general categories list are accepted for treatment.
Patients with the following conditions are accepted for care, subject to availability of facilities:
- apical periodontitis in teeth that have already been endodontically treated
- apical periodontitis in teeth with technical difficulties including calcified canals, severely curved canals and internal resorptions
- endodontic disease caused by dental trauma.
Conditions of acceptance for specialist endodontic treatment:
- the referring practitioner will manage all other treatment required
- patients cannot be accepted simply because they will not pay NHS charges in the GDS or private charges if applicable.
Patients fulfilling the protocols may be referred either to restorative dentistry or to oral and maxillofacial surgery.
Apicectomy is only indicated when endodontic treatment has been impossible to complete because of:
- continuing extra-radicular infection
- a post which cannot be removed
- non-negotiability of root canals
- management of perforations.
- biopsy of a suspicious periapical lesion
The following factors need to be taken into account when considering patients for implant treatment:
- Partially dentate patients should have otherwise healthy intact dentitions, i.e., good oral hygiene, periodontally healthy, minimal restorations and good long term prognosis.
- Patients losing teeth through periodontitis, endodontic failure, and bridge failure are not usually considered for implant treatment.
- Replacement of posterior teeth is considered a low priority and not usually accepted.
- The mere fact that a patient would like to have their existing denture replaced by an implant retained prosthesis or dislikes the thought of wearing dentures does not justify the use of limited NHS funding unless the patient falls into one of the priority categories.
Patients in general categories list are normally accepted if they are in the following categories:
Edentulous in one or both jaws
- Severe denture intolerance
- Physical due to severe gagging
- Physical due to severe ridge resorption with unacceptable stability or pain
- Prevention of severe alveolar bone loss
- Moderate ridge resorption in patients under the age of 45
- Moderate resorption in one jaw opposed by natural teeth with a good prognosis
Preservation of remaining healthy intact teeth when the patient has missing teeth due to:
- Developmental disorders (oligodontia/anodontia or cleft lip/palate)
- Complete unilateral loss of teeth in one jaw where dentures are not tolerated or an edentulous span considered too difficult to manage by other means
Maxillofacial and craniofacial defects
- Intraoral implants. This group of patients have missing significant amounts of hard and soft tissues in addition to loss of teeth. They result from developmental disorders, trauma and the treatment of tumours.