Chester Community Dental Service – Fountains Health Centre

Services covered: Community Dental Services, CWW Level 1 Sedation, CWW Level 2 MOS, CWW Level 2 Sedation, Paediatric services, Special Care Dentistry

What services are offered?

Anterior Apicectomies under sedation
Inhalation Sedation
IV Sedation
Multiple extractions under sedation
Restorative procedures under sedation
Routine extractions under sedation
Simple surgical extractions under sedation

Difficult extraction of erupted teeth
Removal of buried roots and fractured root fragments
Removal of simple impacted teeth, including wisdom teeth
Removal of ectopic and supernumerary teeth
Surgical endodontics on anterior teeth.
Anterior Apicectomies

Which services are not offered?

Complex Medical Histories
Complex Oral Medicine
Complex Surgical Extractions
Domiciliary
G. A. Referrals
HSC Cancer Referrals
Orthodontic Exposures
Radiography
Second Opinions
TMJ
Endodontics

Prosthodontics
Periodontics
Molar Endodontics Under Sedation
Surgical exposure of buccally displaced teeth with an orthodontic treatment plan
Face to Face Restorative Triage Services
Multiple extractions
Simple restorations – direct and indirect
Anterior endodontics
Simple extractions
Simple scaling and debridement

What are the referral criteria for patients?

Level 2 procedures are performed or managed by a dentist with additional competencies above those defined by the Curriculum for Dental Foundation Training but below the level of a specialist as defined by the GDC.

Level 2 Oral Surgery is provided under LA with or without the adjunct of IV sedation.

The patients must be effectively fit and healthy (ASA 1 or 2) as the work is carried out in a community clinic outside hospital surroundings, with no other medical back-up than would be found in dental practice. We would accept patients with mild systemic illness that does not significantly impact on their day to day life.

Services for bariatric patients are offered.

Minor oral surgery services/sedation for nervous adults

What are the main reasons for rejecting patients?

Routine extractions (even if the patient is anxious and requests IV sedation)

Orthodontic extractions

Management of dento-alveolar trauma including alveolar fractures and avulsed teeth

Cases with a previous history of difficult extractions. Each extraction should be assessed on its individual merits

Cases where anaesthesia could not be achieved. The Oral Surgeons do not use any more effective techniques or LA than a GDP would have access to in practice. If anaesthesia cannot be achieved and in the rare cases that the tooth cannot be extirpated or dressed to treat the pulpitis the patient may require referral to secondary care where there is the option of a general anaesthetic

Any referrals with incomplete data sets will be returned – no contact telephone number, no GP details, no xrays, inadequate xrays.

Patient is under 16.

Who are the clinicians providing the service?

Who can use the service?

Patients living in the Cheshire,Wirral and Warrington area or patients attending a GDP of this area.

Patients aged 16 or over.