Sir, whilst working in several A&E departments as part of my postgraduate training in oral and maxillofacial surgery (OMFS), it struck me just how many patients with dental complaints present to the emergency department. The vast majority of this population are managed by the OMFS team.

Now I am medically qualified and working in A&E again, I am still amazed at the number of patients seen with dental problems. Most of them that I have seen are not registered with a dentist. Their management easily falls within the remit of a dental surgeon's capabilities, but poses a real challenge to doctors due to both their very limited training in all orofacial disease and trauma and the lack of appropriate materials and equipment in the emergency department setting.1 This problem is compounded by the redistribution of OMFS service provision from a central 'hub' hospital which means many busy teaching and district general hospitals do not have an OMFS team on site. I would really like to encourage dentists to make contact with their local A&E departments with regards to providing contact numbers and full details of the dental services they can offer so patients are referred to local dental practices when seen in A&E with dental complaints. The literature states that less than two thirds of A&E senior house officers have knowledge of such details.2 Until such a time when doctors are competent and confident in managing these patients, they need to see a dental surgeon.

This would be beneficial for doctors, dentists and most importantly, patients. Patients can be given appropriate information and sent directly to a dentist, avoiding the need for lengthy waits in A&E to be seen by a doctor who has little to offer or the onward referral to OMFS which may well involve transfer to another hospital.