Robertson DP, Keys W et al. BMJ 2015; 350: h1300. 10.1136/bmj.h1300

This paper gives general medical practitioners a guide to manage acute dental infections. And for dentists, it is apposite to revisit the signs and symptoms associated with this potentially life-threatening condition. The 'red flag' symptoms are, facial swelling, trismus, dysphagia or systemic upset. Patients showing these symptoms require immediate referral for management by an oral and maxillofacial surgeon. Furthermore, if the medical practitioner is unclear about the diagnosis and appropriate treatment, they should refer this patient to a dentist, rather than empirically prescribe antibiotics. Less familiar signs of severe infection are tachycardia, tachypnoea, hypotension and WBC <4 × 109 cells/l or >12 × 109 cells/l, or >10% immature neutrophils. There is a note of caution for medical practitioners; '...indemnity would not cover a medical practitioner for the management of a dental problem as it is classed as being outside the scope of their practice.'