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NHS Wales Dental Referral Management System
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There are a range of NICE guidelines that are of relevance to the dental practitioner. We have highlighted these below that we think are the most important. Many of these guidelines are featured in our free online learning courses, just head to the Learning Zone for verifiable CPD.

  • Cancer
  • Safeguarding children
  • Dental Recall
  • Extraction of Wisdom Teeth

Suspected cancer: recognition and referral

This guideline updates and replaces NICE clinical guideline CG27 (published June 2005). It offers evidence-based advice on the recognition of and referral for suspected cancer in children, young people and adults. New recommendations have been added about recognising suspected cancer and referral. The recommendations have been organised by symptoms and investigation findings, as well as by the site of suspected cancer. The guidance also updates and replaces recommendations 1.1.2 to 1.1.5 in Lung cancer (2011) NICE guideline CG121 and incorporates recommendations from section 1.1 in Ovarian cancer (2011) NICE guideline CG122. Download here.

Safeguarding Children.

The advice in this guideline covers the alerting features in children and young people (under 18 years) of:

  • physical, sexual and emotional abuse
  • neglect
  • fabricated or induced illness.

The guideline does not specifically look at:

  • risk factors for child maltreatment
  • the identification of child maltreatment and procedures for supporting the child or young person
  • education and information for parents or children or young people
  • training for healthcare professionals
  • child protection procedures.

Download here

Dental Recall

The NICE dental recall clinical guideline helps clinicians assign recall intervals between oral health reviews that are appropriate to the needs of individual patients. The recommendations apply to patients of all ages (both dentate and edentulous) receiving primary care from NHS dental staff in England and Wales. The guideline takes into account the potential of the patient and the dental team to improve or maintain the patient’s quality of life and to reduce morbidity associated with oral and dental disease. The recommendations take account of the impact of dental checks on: patients’ well-being, general health and preventive habits; caries incidence and avoiding restorations; periodontal health and avoiding tooth loss; and avoiding pain and anxiety. This guideline does not cover:

  • recall intervals for scale and polish treatments
  • the prescription and timing of dental radiographs
  • intervals between examinations that are not routine dental recalls; that is, intervals between examinations relating to ongoing courses of treatment
  • emergency dental interventions or intervals between episodes of specialist care

Responsibility for undertaking a review of this guidance at the designated review date has passed to the National Clinical Guidelines Centre for Acute and Chronic Conditions (NCGCACC). The National Collaborating Centre for Acute Care is no longer active. Download here

Third Molar Extraction

NICE has recommended that:

  • Impacted wisdom teeth that are free from disease (healthy) should not be operated on. There are two reasons for this:
    • There is no reliable research to suggest that this practice benefits patients
    • Patients who do have healthy wisdom teeth removed are being exposed to the risks of surgery. These can include, nerve damage, damage to other teeth, infection, bleeding, and, rarely, death. Also, after surgery to remove wisdom teeth, patients may have swelling, pain and be unable to open their mouth fully.
  • Patients who have impacted wisdom teeth that are not causing problems should visit their dentist for their usual check-ups.
  • Only patients who have diseased wisdom teeth, or other problems with their mouth, should have their wisdom teeth removed. Your dentist or oral surgeon will be aware of the sort of disease or condition which would require you to have surgery. Examples include untreatable tooth decay, abscesses, cysts or tumours, disease of the tissues around the tooth or where the tooth is in the way of other surgery.

Download here  

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