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All Maxillo-Facial conditions

Find assessment and management information at Brisbane South HealthPathways under:

Useful management information

No other management information at this time.

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral

  • Planned radiotherapy to jaws/neck for CA therapy (where general dentist is unable to manage any planned extractions within 1 month)
  • Uncontrolled oral infection/ulceration
  • Simple trauma
  • Acute TMJ injury (not chronic)
  • Suspected malignancy or undifferentiated
  • Uncontrolled facial pain
  • Oral/facial trauma not requiring immediate treatment (within one (1) week)
  • Non-healing of extraction sites, especially PH radiotherapy
  • Non healing wounds

Examples (not an exhaustive list):

  • Undisplaced mandibular fracture
  • Closed maxillary fracture
  • Simple orbital fractures
  • Simple zygomatic fractures
  • Tooth displaced within maxillary sinus
  • Tooth displaced in sublingual space
  • Lefort 1, 2 and 3 fractures without head or neck injury
  • Frontal sinus fractures without head or neck injury
  • Ulcer in the mouth lasting longer than 14 days
  • Other oral mucosal lesions
  • Lesions of the jaw of uncertain nature i.e. potentially malignant (odontogenic or otherwise)
  • Chronic Osteomyelitis
  • Oral/facial lumps/swellings increasing in size
  • Deteriorated dentition requiring extraction of teeth pre radiotherapy (need referral from Rad Onc or Head and Neck, otherwise usually a dentist)
  • Acute unmanageable dental infection including infected metalwork from previous surgery
  • Fracture non-union, mal-union
  • Oral-antral fistula
  • Infected bone plates
Category 2
(appointment within 90 calendar days)
  • Pain, adequately controlled
  • Facial/jaw cyst
  • Chronic infections
  • Salivary gland pathology (non malignant)
  • Biopsy proven benign pathology
  • Congenital conditions

Examples (not an exhaustive list)

  • TMJ dysfunction pain, locking or recurrent dislocation
  • Benign odontogenic lesions (dentigerous cysts, keratocysts)
  • Benign salivary lesions (pleomorphic adenoma, warthins tumour)
  • Sinus pathology
  • Salivary calculi
Category 3
(appointment within 365 calendar days)
  • Benign oral medical conditions
  • Congenital or developmental malformations
  • Cranial-facial rehabilitation
  • Non-malignant growths

Examples (not an exhaustive list):

  • Lichen planus
  • Ulceration
  • Xerostomia
  • Prognathism, maxillary hypoplasia
  • Branchial arch abnormalities
  • Hypodontia, delayed eruption of teeth
  • Ankyloglossia (tongue tie or other frenum release)
  • Post traumatic deformities (orbital dystopia)
  • Chronic TMJ dysfunction (osteoarthropathies)
  • Implants e.g. ears, eyes etc.
  • Oral/ dental for cleft palates, missing teeth
  • Fibroma, haemangioma
  • Fibrous dysplasia
  • Hyperplastic tissue
  • Bony enlargement e.g. Mandibular, Maxillary, palatal exostoses/ tori
  • Referral for orthognathic surgery (all referrals must be from an Orthodontist)
  • 3rd molar removal
  • Surgical dental extractions
  • Chronic TMD

If your patient does not meet the minimum referral criteria

  • Assessment and management information can be found on a range of conditions at SpotOnHealth HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

 

Essential referral information for All Maxillo-Facial conditions referrals (Referral will be returned without this)

Facial Fractures:

  • CT face
  • Contact registrar to arrange an outpatient appointment within 5-7 days

Mandibular fractures:

  • OPG and PA mandible (plain films)

Salivary Glands:

  • Sialogram or US or CT as indicated

Skin Cancer (head/neck/face):

  • Any biopsy results

Orthognathic cases or Facial Deformity:

  • OPG
  • PA ceph
  • Lateral ceph (plain films)

Dental or Bony pathology:

  • OPG

TMJ:

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional referral information for All Maxillo-Facial conditions referrals

Nil.

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 23 February 2024