I was asked by the professional magazine Pulse to discuss the question of whether GPs can refuse to treat dental abscesses.
A study published in 2016 reported that around 600,000
consultations annually with GPs are for dental problems. Reasons why people
present to GPs with dental problems include the poor provision of NHS dental
services in many parts of England and the £19.70 charge that some patients must
pay for a dental consultation. If you decide that your patient may have a
dental abscess, assuming there are no red flags (such as signs of spreading
infection or sepsis) that would warrant an urgent referral for emergency hospital
assessment, then the patient should be informed that they need to see a
dentist. You should explain to the patient that a dentist is trained to treat
dental abscesses but you are not. The dentist has the expertise and equipment
needed to assess the patient, carry out suitable investigations (such as dental
radiographs), and drain the abscess if this is required. The dentist can also treat
any underlying problems, through procedures such as root canal treatment or a
tooth extraction, to minimise the risk of recurrence of the abscess. You should
also explain to the patient that issuing an antibiotic is an inadvisable course
of action for GPs for someone with a suspected dental abscess as this won’t
address the underlying problem; may mask symptoms and result in a worse
long-term outcome for the patient; and will encourage the development of
antimicrobial resistance. If the patient does not have a regular dentist, inform
them they can call NHS 111 or use the NHS Choices website to find the location
of local services for emergency dental treatment. It is NHS England and NHS
commissioners, and not GPs, who are responsible for ensuring the population has
access to adequate NHS dental services. This includes access to services for
emergency dental treatment.
The published article can be read in Pulse, along with the views of two other doctors.
Comments