Manchester Dental Hospital has provided further details on the cases that they will consider for acceptance. You can view them at their website here and they are provided below for your information.
We are unable to accept referrals for endodontics (either primary or retreat) if the tooth is not of strategic importance – this would, for example, include teeth that are supporting essential bridgework, or if the tooth contributes to the maintenance of a functional dentition (normally a shortened dental arch of 10 occluding pairs). Most cases accepted for treatment will be taken to a point where the referring practitioner should be able to complete treatment.
Referrals not fulfilling the following criteria shall be rejected:
- De-novo treatment has been attempted
- There is a specific problem with the tooth, which cannot otherwise be treated in general practice (cases of complexity 1 and 2 difficulty will normally be referred back with advice); for example:
> complex root canal anatomy (such as sclerosed canals or excessive curvature)
> separated instruments
> management of open apices, resorption and trauma
- The tooth is of strategic importance to the patient in terms of function (normally a shortened dental arch of 10 occluding pairs)
- Molar teeth can only be considered for endodontic treatment if they are strategically important teeth to maintain function, or if they are important to the retention of a prosthesis.
- The tooth is restorable and functional; it is the responsibility of the referring dentist to ensure that the tooth is caries-free, has good periodontal prognosis and any unsatisfactory restoration has been replaced to ensure a coronal seal is achieved.
- Where the medical history supports endodontic therapy over extraction (e.g. risk of osseonecrosis due to bisphosphonate medication or previous radiotherapy)
- The patient is a regular attender in practice and is well motivated with no active caries or periodontal disease.
- The letter of referral contains an indication of the history of the problem and of the treatment carried out to date.
- A recent (within 3 months) high quality periapical radiograph of the tooth in question must be sent with the referral letter. Digital print-outs must be of diagnostic quality.