Do I need a referral to be seen?

Not always. Most of our patients arrive by referral from a general dentist or an orthodontist, and that route works best because we start with your records and imaging. You can also contact us directly, particularly for a second opinion or for a lesion you are worried about.

How do I send a referral?

Through the secure portal, by encrypted email, or by fax — whichever your practice already uses. The form on the referring doctors page covers everything we need. Anything urgent should be a phone call to the direct line rather than a form.

I take a blood thinner. Will it be stopped?

Usually not. Current guidance for simple dental extractions is to continue direct oral anticoagulants and warfarin within the therapeutic range, and manage bleeding locally with packing and sutures. Stopping a blood thinner carries its own risks. We will make that decision with your prescriber where the case is complex, and never by asking you to stop it yourself.

I am on a bone medication. Does that matter?

Yes, and please tell us. Bisphosphonates, denosumab and some cancer treatments are associated with medication-related osteonecrosis of the jaw after extractions and implant surgery. The risk is much higher with intravenous cancer dosing than with tablets for osteoporosis, but it is not zero for either. It does not mean you cannot have surgery; it means we plan differently and talk about it properly first.

What is your antibiotic policy?

Prophylaxis by indication, not by habit. We follow current guidance for infective endocarditis prophylaxis and prosthetic joint patients, and we do not prescribe antibiotics routinely after uncomplicated extractions. Over-prescribing has costs, and we would rather explain that than write a script to end an appointment.

Do you place and restore implants?

Place only. Patients go back to their own dentist for the restoration. We are a referral practice and being in competition with the practices that refer to us would be a poor way to run one.

What happens if something goes wrong at night?

Call the after-hours line. It is answered by one of our surgeons, not a call centre, and it is on the back of every set of written instructions we give out. Bleeding that has not settled with an hour of firm pressure, difficulty breathing or swallowing, or a swelling that is closing your eye or crossing your neck are all reasons to call immediately or go to an emergency department.

Can you see an urgent lesion this week?

Yes. We hold assessment slots every week for suspicious mucosal lesions. Call the direct line rather than sending a form, and we will use one.

Do you treat children?

We see adolescents for third molars, exposure and bonding of impacted canines, frenectomy and pathology. Very young children and those needing extensive care under general anaesthesia are usually better served by a paediatric dental service, and we will say so and help arrange it.

Refer a patient — imaging, the form, and a direct line

01 · Reach a surgeon

Four ways in, in the order we would use them.

If it is urgent, do not use the form. Call. The referral line is picked up by a surgeon or put through to one, and a ten-second conversation moves a patient into one of the assessment slots we hold open every week.

Urgent — the same week

Referral line

(612) 555-0150

Suspicious mucosal lesions, spreading infection, dentoalveolar trauma, a patient you are not comfortable watching. We hold assessment slots for these every week and they are frequently unused.

Routine

Secure formThe referral form below — about two minutes

Email[email protected] — encrypted transport

Fax(612) 555-0151 — still the fastest route for some practices

Office(612) 555-0148 — scheduling and records

02 · What to send with a case

Nine things, and one that matters more than the rest.

The clinical question. "Impacted 38" tells us what you can see. "Recurrent pericoronitis, third episode, patient is a flight attendant and wants it dealt with before the winter roster" tells us what to do about it.

An intraoral digital scanning wand resting on a stainless bench beside its cradle — Scans and DICOM welcome in any common formatE

Patient name, date of birth, telephone number and preferred contact method
Your practice name and the best number to reach you on, not the front desk
What you want us to do — assess, treat, or give an opinion. "Please see and treat" is fine; "please see" is not always enough
The clinical question you actually want answered
Current radiographs, and the DICOM rather than a screenshot if you have a CBCT
A full medication list including anticoagulants, antiplatelets and antiresorptives
Relevant medical history: cardiac, respiratory, bleeding disorders, immunosuppression, pregnancy
Whether the patient has an existing altered sensation — much easier to record now than to attribute later
Whether the patient has a strong view about sedation

03 · Imaging requirements

What we need, by case type.

We would rather look at ten panoramics and say no to nine than not see the tenth. If you are unsure whether a film crosses the threshold for cross-sectional imaging, send it and ask — that is not an imposition, it is the job.

Imaging and records by case type
Case	Minimum imaging	Also send	And tell us
Third molars	Panoramic under 12 months	CBCT DICOM if any canal marker is present	Pericoronitis episodes, trismus, sedation preference
Single implant	CBCT, small field of view	Intraoral scan or models, both arches	Restorative plan: screw or cement, who restores
Full arch	CBCT with the existing denture worn	Scan or impressions, both arches	Full-face photographs at rest and full smile
Grafting / sinus lift	CBCT showing residual height and septa	Photographs and probing chart for soft tissue	Sinus history: sinusitis, prior FESS, obstruction
Orthognathic	CBCT of the facial skeleton + lateral ceph	Scan of both arches, CR bite registration	The orthodontic plan and decompensation endpoint
TMJ	Panoramic as a screen; MRI for disc position	CBCT only for suspected osseous change	Pain history and what has already been tried
Pathology	Periapical or panoramic if there is bone involvement	Clinical photographs with a scale	Site in millimetres, duration, tobacco and alcohol use

The five markers that mean CBCT

On a panoramic, any of these where a third molar root crosses the inferior alveolar canal:

darkening of the root
interruption of the cortical white line of the canal
diversion of the canal
narrowing of the canal
narrowing or deflection of the root

Why each one matters →

Radiation, honestly

A cone beam scan carries a materially higher effective dose than a periapical or a panoramic, and a much lower one than a medical CT. We take a small field of view by default and we do not take one unless it will change what we do.

If you have already taken an adequate CBCT, send us the DICOM and we will not repeat it.

04 · The referral form

Send us a case.

Everything marked required is genuinely required; nothing else is padding. Attach imaging by replying to the acknowledgement email, or fax it to (612) 555-0151 with the patient's name on the cover sheet.

Referring practice

Referring clinician required

Practice required

Direct number not the front desk

Email required

Patient

Patient name required

Date of birth

Patient telephone required — we book directly

The referral

Case type required

Urgency required

The clinical question required — what do you want answered?

Medications and medical history

Imaging you are sending

The patient has consented to this referral and to their records being shared for the purpose of their care. required

Demonstration form. Nothing is transmitted, stored or sent anywhere — this is a design and engineering demo of a fictional practice.

What comes back to you

Same dayAcknowledgement with the triage decision and, where the imaging allows it, our recommendation before the patient is seen.

Same weekConsultation letter with the classification, the anatomy, the plan and the named risks discussed.

Within 24 hOperative note and post-operative regime after any procedure.

ImplantsFixture record: system, platform, diameter × length, insertion torque, ISQ where measured, graft, and the date the site is ready to impress.

PathologyThe histology report the day it lands, and a telephone call if it is unexpected.

Who you will be talking to

Orthognathic & craniofacialDr. Ingrid H. Vestergaard, DDS, MD

Implant & reconstructiveDr. Paul S. Lindqvist, DMD, MD

Pathology, trauma & anaesthesiaDr. Marcus O. Adeyemi, DDS, MD

05 · Where we stand

Policies you will want to know before you refer.

None of this is controversial. It is written down because these are the questions that arrive on referral forms, and because a practice that will not answer them in public is harder to plan around.

06 · Clinical notes

Written for you, not for search engines.

Third molars

Five radiographic markers that mean we want a CBCT

A panoramic film answers most third-molar questions. These five findings are the ones that mean it has stopped answering them.

Dr. Ingrid H. Vestergaard · 6 min

Medical management

Anticoagulants: why we rarely ask patients to stop them

Interrupting anticoagulation to prevent a bleed that can be managed locally trades a small, controllable risk for a large, uncontrollable one.

Dr. Marcus O. Adeyemi · 7 min

Implants

Ridge preservation: refer before you extract, not after

The best time to decide about a graft is while the tooth is still in the mouth. Six months later, the decision has already been made for you.

Dr. Paul S. Lindqvist · 5 min

Refer a patient.