Advanced Education in General Dentistry

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Medical Consults

For medically compromised patients where dental treatment plans will need to be altered due to patient condition, a medical consult form must be filled out. Residents will send the information request via the patient to the medical doctor. The patient will then return the form to the resident and it will be added to the patient’s dental chart. See example of a medical consult form. Any ASA III and IV patient requires a medical consult and medical clearance prior to dental treatment.

When residents are phoning medical doctors for patient consults, it is advised that the resident prepare in advance what to say. In general, the resident should include the following:

  1. Identify yourself (DDS, Dental Resident at UMAB) and your patient.
  2. State the known health condition of the patient.
  3. Describe the dental procedures planned. Medical doctors tend not to have a detailed understanding of these procedures; thus, account the details of the surgery, the extent of bleeding predicted, the intended local anesthetic or medication to be used, and/or the possible effects of the dental treatment on the patient.
  4. Specifically ask the information required from the medical doctor. Examples: “Should antibiotic prophylaxis be administered prior to dental therapy?” “Is the use of epinephrine in the local anesthetic contraindicated?” Avoid asking too general a question like, “Is there anything that should concern me about the patient?”
  5. Document discussion in the Progress Notes of the patient’s record and ask for written documentation from attending physician.