Important notes
This form should be used to refer an adult to Community Special Care Dental Services for a routine dental check-up, when they have been unable to accept dental services in a high street dentist. Only patients who are unable to be examined in a high street dental practice because of some physical, intellectual, medical, emotional, sensory, mental or social impairment, or a combination of these factors should be referred in via this route.
If the person can be seen in a high street dentist, you can arrange a dental appointment:
- If the person has a usual dentist, you can ring them directly and request a appointment.
- If the person does not have a usual dentist, you can ring any local dentist directly requesting an appointment. You can find details of local dentists online or at Find a dentist NHS.
If the person is in pain, and unable to get an appointment with a dentist, you can access urgent dental care:
- Ring the Manchester Urgent Dental Care Service 0333 332 3800 which is available every day 8:00-22:00 including weekends and bank holidays.
- Ring NHS 111 who can assist every day from 22.00 through to 08.00.
You should advise the operator if the person has additional needs and cannot accept dental care in a high street dentist. In this case, the person does not need to be present for this phone call or subsequent telephone consultation. Translation services should be made available.
Please inform the patient or carer that NHS Charges apply and that they should bring to the first appointment proof of any exemptions and the patient or carer will need to sign the NHS form to that effect. If this is not provided the patient will not be accepted for treatment or examination.
The person should be accompanied to the dental appointment by a parent or carer who can provide support and advice about previous history and any current issues. The dentist will discuss future treatment needs at the first appointment and may need to seek further consent before proceeding.
A copy of the referral form and discharge summary, including did not attend, will be emailed to the referrer, the social worker and the GP. If the patient cannot be seen within the Community Special Care Dental Services, you will be advised and directed to the appropriate service.