Borders Ref Help Toolkit
Who can refer:
Referrals to Special Care Dentistry are accepted from primary and secondary health and social care professionals.
Who to refer:
The Special Care Dentistry service accepts referrals for adults from the following priority groups:
Patients with severe or significant special care need(s) in one or more of the following categories:
- Physical impairment or disability
- Sensory impairment or disability
- Intellectual impairment or disability
- Mental Health Conditions
- Complex medical conditions
- Patients whose care cannot reasonably be delivered in a GDS setting as follows:
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- Patients who require a multidisciplinary approach between medical and dental teams to facilitate safe dental care.
- Neurodivergent patients who require additional input/ or modifications to their care which cannot be facilitated within a GDS setting.
- Patients who require haematological cover to be provided for dental treatment (e.g. extractions, minor oral surgery, inferior dental block (IDB) or lingual local anaesthesia).
- Patients with an impairment or disability that cannot be overcome using accessible physical aids.
- Patients whose weight exceeds the safe working limit of the referrer’s dental chair.
- Patients with significant communication difficulties.
- Patients whose social circumstances is a barrier to accessing GDS care (e.g. those who are homeless or have drug dependency issues).
Who not to refer:
The Special Care Dentistry service will not accept referrals for the following:
- Patients with lesions in their mouth considered ‘urgent suspicion of cancer’ Referral should be made directly to the Oral & Maxillofacial Surgery service at St John’s Hospital using the specific SCI Gateway.
- Patients with mild or moderate special care need(s) whose care can be reasonably delivered in a GDS setting.
- Patients requiring domiciliary care (see oral health improvement guidance)
- Patients who are at low risk of Medication-related Osteonecrosis of the Jaw (MRONJ) .
- Patients taking anticoagulants or antiplatelet drugs whose INR is maintained below 4 and have no other relevant medical complications.
- Patients' resident out with the boundaries of NHS Borders (applies to primary health and social care referrals).
How to refer:
Referrals to Special Care Dentistry are accepted from primary and secondary health and social care professionals.
- GDPs providing NHS dentistry must refer to NHS Borders Public Dental Service via SCI Gateway. Any other route of referral will be rejected.
- If you are a primary / secondary care health or social care professional without access to SCI Gateway, please email bor.pdsreferrals@borders.scot.nhs.uk. or refer to:
Public Dental Service Department,
Borders General Hospital,
Melrose,
TD6 9BS
- If a referral is urgent in addition to the above, please contact the Oral/Dental/Orthodontic Secretary on 01896 826201
Please note that the secure transmission of emails containing patient information is the referrer’s responsibility
Referrals should be completed as fully as possible, forms with incomplete information will be rejected. Relevant radiographs / images should be included in your referral. These can be sent as an ‘attachment’ in SCI Gateway. If you are not registered with SCI Gateway, please provide the images in an alternative accessible format.
Required information to be included in referrals:
- Reason for referral – why the procedure cannot be managed in the routine practice setting
- Details of any oro-dental pathology
- History of presenting complaint including any pain, swelling
- Full medical history including medication, allergies (a scanned up to date form is entirely acceptable)
- Previous dental history
- What treatment has been attempted in GDS (and what modalities used) including details of emergency care provided if patient in pain/other symptoms
- Summary of oral hygiene level, BPE score, any proactive preventative measures undertaken
- Stability of dentition
Discharge criteria:
Patients will be discharged from the care of the Special Care Dentistry service for the following reasons:
- Their care can be reasonably delivered in a GDS setting.
- They have completed a course of treatment
- They fail to attend or repeatedly cancel their appointments at short notice. The referrer will be duly informed. For patients still wishing to be treated by the Special Care Dentistry service, a new referral will be necessary.