• For use on the Heatherwood Hospital and Wexham Park Hospital sites.

This is a controlled document. If you are using a printed copy, check it against the guidelines site to ensure you are using the latest edition.

Print copies must be destroyed after use.

The National Institute of Clinical Excellence (NICE) has published referral guidelines for third molars which are available at their website (www.nice.org.uk/guidance/ta1)

Patients will normally only be offered surgical removal of thirds molars if they fulfil these guidelines.

Indications include:

• Multiple episodes of pericoronitis

• Caries leading to pulpal exposure

• Periodontal disease

• Medical “prophylaxis” e.g. for cardiac surgery or endocarditis

• Periapical pathology

• Restorative considerations

• Fractured tooth

• Resorption or caries of adjacent teeth

• Association with a mandibular fracture

• Prior to orthognathic surgery

• Association with a cyst or tumour

Anterior crowding, if it occurs in the absence of any of the above, is not an indication for third molar removal.

Please ensure that relevant radiographs accompany all requests so that we can help to avoid unnecessary radiation exposure to patients. These radiographs will be returned once treatment has been completed.

If you are referring a patient because they request treatment under general anaesthesia, please ensure that the General Dental Council guidelines with regard to risk counselling have been followed and that evidence of this is provided in your letter