Sir, I recently conducted an audit into basal cell carcinoma (BCC) excisions performed by a maxillofacial surgeon at the hospital unit where I am completing my DF2 year. An example of a BCC is shown in Figure 1.

Figure 1
figure 1

BCC in a young patient, easily visible in the beam of a dental light

Full size image

Of the 247 BCC lesions which were excised within one year, 228 (92%) were removed from the head and neck. Over half of the excisions were removed from areas generally visible to a dentist during an examination and 26% were within the field of the dental light.

Interestingly, of the 247 cases, not one patient was referred in by their general dental practitioner. It may be possible that none of these patients had needed to see their dentist before they visited their GP, or perhaps the lesion was picked up by the general dentist who referred to the GP as opposed to the specialist directly.

This is a useful reminder that as medical healthcare professionals we can also refer directly to the secondary care specialist and that our extra oral examination can be just as important as the intra-oral one.