Letter | Published:

Identifying teeth correctly

BDJ volume 223, pages 551552 (27 October 2017) | Download Citation

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Sir, I would like to take this opportunity to remind clinicians that when a patient is referred for dental extractions for orthodontic reasons the teeth to be removed are identified by at least two methods. One should be in dental notation (Palmer, FDI or abbreviation) and the other should be in words. This is in line with the British Orthodontic Society Orthodontic Extractions Risk Management Guidelines.1

A recent audit carried out at Cambridge University Hospital Oral and Maxillofacial Surgery department revealed that only half of referrals for extractions for orthodontic reasons fulfilled the guideline criteria. Fortunately, there has been no wrong site surgery amongst the cases audited but there have been two instances of delay in treatment provision.

It is of utmost importance that teeth are identified correctly particularly in the case of extractions carried out as part of orthodontic treatment as these rarely have any distinguishing pathological abnormality. The justification therefore often lies within the hands of the referring clinician who has more insight into the orthodontic treatment plan and objectives. Incorrect identification of the teeth to be extracted poses a serious risk of wrong site surgery, which is featured in the NHS Never Event List.2 At the very least poor identification of the teeth to be extracted can result in increased expenses and delay of treatment provision, as further appointments may be needed whilst seeking clarification from the referring clinician.


  1. 1.

    British Orthodontic Society. Orthodontic Extractions Risk Management Guidelines Advice Sheet. 2014. Available at: (accessed March 2017).

  2. 2.

    National Health Service England Patient Safety Domain. Never Events List 2015/16. 2015. Available at: (accessed October 2017).

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    • V. Kostova


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