Dental Referral Form Template 

Oral health is an essential element of general health and well-being. Ignoring oral health means risking overall health. Dental practitioners help patients improve and maintain their oral health by assessing their circumstances, detecting issues, and providing the best possible care. Sometimes, a dentist might not possess the requisite expertise or equipment to perform a specific dental treatment.

He/she might refer the patient to another dentist who is more qualified and equipped to perform the procedure or provide a diagnosis. In such cases, the dentist fills up a dental referral form to refer the patient to another dentist.

What is a Dental Referral Form?

A dental referral form is a document that is used to refer patients for dental treatments from one dental professional to another. When a dentist recognises a patient’s need that he feels can be better taken care of by another dentist, then he fills out a dental referral form and refers the patient to that dentist.

If you are a dental practitioner, you need to understand what is best for your patient and if you think that the patient requires treatment that goes beyond your area of specialisation, then you need to refer them to another specialist. Even by referring the patient to another dentist, you can easily manage the overall health and well-being of the patient. With the help of a dental referral form, dentists can easily refer a patient from one dentist to another.

Why does a Dental Referral take place?

There are several cases wherein a dentist refers a patient to another dental practitioner:

1. When patients have neuromuscular or cognitive benefits
2. When the treatment requires the care of another specialist
3. When the patient requires extensive treatment pertaining to trauma or oral cancer
4. When a patient requires comprehensive dental work
5. When the cost of providing the treatment is not in the best interests of the dentist
6. When a patient requires the care of multiple specialists
7. When a patient has an occlusal deficiency

Legal Requirements of a Dental Referral Form (According to the American Dental Association)

According to ADA’s General Guidelines for Referring Dental Patients, it is important to keep the patient’s needs in mind while making specialty referrals. Only dental practitioners can assess whether their education, experience, and skills can serve their patients. Whenever a patient is referred by a dentist to another specialist, there is a need for constant communication between the patient and the providers, to ensure that the best care is provided.

The ADA recommends the following practices for dentists while referring patients:

1. Discuss the course of the treatment with the patients and the reason why they’re being referred.
2. If the dentist has a limited network of dental practitioners, then they need to reach out to dental schools, the local dental society, or their mentors to provide the right referral.
3. If the patient has any existing medical condition then there needs to be an evaluation from their physician before dental treatment can be carried out.
4. The dentist needs to be transparent with the patient in terms of making the appointment, the fee involved, the area of dentistry that the provider specializes in, or any preoperative instructions.

Things to include in a dental referral form:

1. Patient information (Name, Email ID, Phone number, Address, Age, Gender)
2. Information of the dentist that is referring the patient (Dentist’s name, Name of the practice, Dentist’s contact information)
3. Reasons for the referral (Name of the treatment/procedure)
4. Details of treatment requested (Teeth that need to be treated)
5. Details of the dentist referred (Name, contact details, address)
6. Patient history (If the patient has any preexisting conditions, what all treatments the patient has received in the past)
7. Immediacy: Emergent/Urgent/Routine
8. Detailed instructions (if any)
9. Remarks
10. Date
11. Signature of the referring dentist

FAQs

1. What does a dental referral mean for a patient?
   A patient is referred to another dental provider when his/her treatment is beyond the expertise of the dentist. A patient can also be referred for specialised treatment to another provider when his/her existing provider doesn’t have the equipment to perform a certain procedure.
   The patient needs to not just communicate with both providers about the treatment that he/she is about to receive but also trust the process and the dentists.
2. What are the key uses of a dental referral form?
   A dental referral form is a great way to reassure patients about their oral condition and the diagnosis and treatment regarding the same. Also, when a dentist refers a patient to another provider, it builds the confidence and trust of the patient in the dentist.
   Referring a patient to another provider takes a great deal of thought and is always done to protect the interests and needs of the patient concerned. A dental referral form helps the patient and the providers understand the current condition of the former and what steps need to be taken to ensure good oral health.
3. What does a dental referral mean for the referring dentist?
   Care and caution are the two elements that dentists need to take into account while treating a patient. If they think that the patient needs specialised and broader care in a particular area of dentistry, then they must refer the patient to a specialist.
   Irrespective of the discomfort that the dentist might face while referring the patient to another provider, the needs of the patient should always be prioritised. Referring the patient doesn’t mean that the patient has been completely handed over to another provider. Constant communication needs to be maintained for the comfort of all those involved.
4. What does a dental referral mean for the dentist being referred?
   The referred dentist needs to carefully analyse the dental referral form and assess the existing condition of the patient, the type of care required, and the degree of emergency. He/she also must constantly communicate with the patient and the referring dentist to completely understand the case and provide the best possible care.
5. Can dental referrals expire?
   Yes, dental referrals can expire. When patient waits long enough after being referred to another dentist, they can experience changes in their oral health conditions, and the assessment given long back might not stand accurate at that point in time. So, it is always advised to avail treatment right after the dentists refer the patients.