A referral is defined as a recommendation of assistance in achieving complete quality health care management.

A referral may be from primary care to secondary care, having same principles improving the welfare of the patient. Referrals should be based on the education, training, interest, experience of the referring dentist and the unique needs of the patient.

Each referral requires a constant transfer of information between the referring clinicians and, in many cases, a specialist. This information may be taken verbally or in written form. Oftentimes, referrals are elective process following a discussion between the patient and clinician regarding their treatment options. While on other occasions, the referral may require the immediate attention of a specialist to deal with an urgent concern raised by the patient or clinician.

In order to facilitate the efficient referral of a patient, each dentist should have a clear understanding of the role each is playing in providing care to the patient.


PRIMUM NON NOCERE- This is a Latin phrase that means, “First, do no harm”.

As dentists, our primary duty is to protect our patients from harm. We should be aware of our own limitations and know when to refer to a specialist.

Every dentist differs in his or her level of expertise. Some may have undergone post-graduate training or may have acquired certain skills from work experience. These raise their confidence in handling complicated or advanced dental cases.

In cases wherein you are faced with uncertainty, which can lead to mistreatment and unwanted complications on your patients, it is only appropriate to do a referral to a specialist. But whether you are a general dentist or even a specialist, you may face this legal and ethical dilemma. Legally speaking, misdiagnosis and mismanagement can lead to unnecessary lawsuits due to malpractice. On the other hand, doing procedures with the knowledge that this is beyond your expertise is ethically unacceptable.

Always put your patient’s welfare above your own personal or professional interests and ensure that the ideal standard of care set by the profession are met.


The following conditions can provide us the appropriate rationale for referring a patient. Some of these situations include, but are not limited to:

  • Level of training and experience of the dentist
  • Dentist’s areas of expertise and interest.
  • Extensiveness of the problem.
  • Complexity of the treatment.
  • Medical complications
  • Patient load
  • Availability of special equipment and instruments
  • Staff capabilities and trainings
  • Behavioural concerns
  • Geographic proximity of the specialist or consulting dentist


The referral form should serve as a quick overview of the case for the specialist or consulting dentist.

The referring dentist should convey pertinent information to the specialist or consulting dentist.

This information may vary on an individual patient basis including:

  • General Data: (Name, Age, Sex and Address of the patient)
  • Scheduled appointment date and time with the specialist or consulting dentist
  • Reason for the referral/diagnosis
  • General background information about the patient which may affect the referral
  • Authorization or release of records
  • Medical and dental information, which may include:
  • 1. Medical consultations and specific problems
    2. Contributory dental history
    3. Diagnostic casts
    4. Radiographic or digital images

  • Future treatment needs beyond the referral
  • Urgency of the situation, if an emergency
  • Information already provided to patient
  • Treatment that would be provided by the specialist limited to the nature, scope and reason outlined in the referral.


The referring clinician should have a personal knowledge of the specialist or consulting dentist who can competently deal with your patient’s dental needs. Inquiries about training and experience may assist the referring dentist in determining who to refer that particular dental patient. A visit to the office to observe treatment is optional but may be helpful for you and the patient.

Encouraging questions from patients about the referral and responding in layman’s terminology can ease some of the apprehension associated with unfamiliar treatments and/or the provider who will do it on your behalf. If language barrier exists, every effort should be made to ensure that the patient fully understands the reason/s for the referral. It may also be helpful for you to have a list of dentists and their corresponding specialties within your area as a guide.

You may download a Referral Form DMD Center made for you to use.

Referral Form


In conclusion, we all do have some worries when we refer our patient to another colleague such as the patient may not return back to you as a patient either due to the unethical actions of your colleague stealing him/her away from you or your colleague’s error on the treatment or your patient’s perception if you refer her/him to another dentist and all other stuff that may do go wrong. However, we should all look at referring our patients to another dentist or specialist we trust, when it is necessary, in a positive and good perspective that actually brings more benefits than liabilities to you and your dental practice. Remember, knowing how and when you need to refer simply what kind of a dentist you are, a conscientious dentist who cares enough to put your patient’s well-being first rather than any financial or selfish gain.


Dr. Bryan Anduiza – Writer
Dr. Jean Galindez – Writer | Editor


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