Your interest and participation in this site is wholeheartedly welcome. We hope that this site won't be needed too often for referrals as these conditions are thankfully relatively uncommon. However, at the same time we want to highlight how dreadful chronic orofacial pain can be for the patients and to illustrate to you how easy it is to diagnose and manage them!
We aim to provide reliable information, which is evidence based information where possible, to educate patients on how best to cope and manage their pain and associated system. In addition we aim to reduce the number of clinical visits for orofacial pain patients by highlighting the issue and by providing better education for clinicians both qualified and in training.
There is a set of pathways for patient referrals.
If you are worried about the urgency of your patient referral for nerve injuries, check our website www.trigeminalnerve.org.uk. If you are worried about a pain patient urgent referral check our Red Flags document.
Referral information for dentists
Routine referral to the Orofacial Pain Service at Kings College Hospital is advised for:
- GDPs/GPs who require diagnosis and treatment/medication recommendations
- Patients with a condition who require specialist management (e.g. complex treatment required/excessive demands/severe side effects)
- Patients requesting specialist information/prognosis on their condition
- Pain that has persisted for more than three months
- Patients with TMD that has not been alleviated by standard management
- Widespread pain
- Patients with special needs
Urgent referral (red flagged referrals) to the Orofacial Pain Service at Kings College Hospital is advised for:
- Patients who have increasing distress/disability or Psychiatric issues
- Suspected tumours
- Acute Trigeminal Neuralgia
- See Red Flags document for more information
Referrals should be clear and contain all relevant information using this proforma or by letter using proforma as guideline for content.
All patients will be sent a Questionnaire Pack.
Consultation involves several aspects.
And pathways are explained after referral the patient will be copied into an outcome letter back to you.
Please advise patients of NHS waiting times (maximum 18 week national target) and advise that questionnaires will be sent and medication list will be required on the day of appointment.
KCH Dental Hospital
London SE5 9RS
General clinic policy
The Clinic will provide treatment of a consistent and very high quality for all patients and appreciates that many will feel some inevitable and understandable apprehension.
- All patients will be communicated to in a courteous and professional manner.
- All patients will be asked about their general health, including any daily medications, to ensure safe treatment.
- All proposed treatments and other options will be explained and discussed with each patient so that they are able to make an informed decision regarding their treatment.
- Referring practitioners will be kept informed of all patient decisions and planned treatments.
- No treatments will be carried out without the patient's full consent.
- All patient-related information will be kept strictly confidential.
- Cross-infection and contamination control is essential for patient safety.
- Oral Surgery Clinic has policies and systems in place to ensure infection control which will always be fully understood and implemented by both surgeon and nurses.
- Patients' views are of prime importance and are listened to.
- Patients will be routinely asked to provide feedback on different aspects of the treatment they have received.
- All feedback will be considered and reflected on, with changes being implemented as necessary.
- Systems are in place to deal promptly and sympathetically with any patient complaints and the Clinic's policy for such events is set out below.
The clinician and nurses regularly take part in continuing professional development as required by General Dental Council, with a particular emphasis on all aspects of and guidelines relating to Oral Surgery and the provision of intravenous sedation. Changes will be implemented where relevant when this is supported by clinical studies within the Oral Surgery clinical literature.
The General Dental Council (GDC) is the regulatory body of the dental profession in the UK. Their address is 37 Wimpole Street, London W1G 8DQ, tel. 0207 887 3800 and website www.gdc-uk.org.
All staff are registered with the GDC and follow the rules governing the profession as set out by the GDC within their document "Standards for Dental Professionals".
Oral Surgery Clinic is fully compliant with the Data Protection Act 1998.
Oral Surgery Clinic follows the standards for patient confidentiality as set out by the General Dental Council within their document "Principles of Patient Confidentiality" which can be downloaded at their website.
Dental school, we take complaints very seriously and try to ensure that all patients are pleased with their treatment experience. If a patient complains, they are to be dealt with courteously and promptly so that the matter is resolved as quickly as possible.
Our aim is to react to complaints in the way in which we would want our complaint about a service to be handled in accordance with NHS governance regulations. We are well aware that we can learn from any mistake that we make and we will therefore respond to customers' concerns in a caring and sensitive manner.
Clinicians and patients are reminded of the requirements to notify the Care Quality Commission of injuries to the nervous system. These can be reported to the Commission using the form which can be found at www.cqc.org.uk under “Organisations we regulate”
What happens with your patient referrals
After patient referral patients will be asked to complete data online On referral we have several questionnaires we need your patient to complete before they see us. They include;
- Patient details
- Patient medical history
- Details of Patients nerve injury (how when it happened)
- What pain, altered sensation your Patient is experiencing
- What functional difficulties your Patient is experiencing
- Psychometric questionnaires (7 of them)
- Euroquol (EQ-5D-5L)
- HAD score
- OHIP 14
- PCL (Brief version)
- PCS score
- Pain detect
All this data is stored anonymously and securely as you are given a coded login and password once you have been referred to us. We can then construct a report from your data and formulate a summary sheet of your history and presentation that will help us with your consultation appointment and our research On attending clinic the patients may be approached to participate in further research including;
- Consent to provide patient videos
- Consent for bloods for genetic assessment of neuropathic pain related to post surgical neuropathy
- Consent to complete specific additional questionnaires
If reparative surgery is planned;
The patient will be asked to provide samples of nerve, mucisa and blood during the procedure to assess pain receptor biomarkers at sites affected by nerve injury Consent will also be sought for digital photography.
Ongoing additional research in our department
- Research aims and objectives
- Summary of ongoing and planned research in trigeminal pain in man at KCL
Short term Goals
- Development of trigeminal pain clinical / psychological research teams for chronic orofacial pain
- Development of expertise for chronic orofacial pain
- Identification of research area needs using Cochrane review
Medium term goals
- Evaluation of ongoing service developments for chronic orofacial pain
- Build on existing links with IoP, Neurology, Neurosurgery, Physiotherapy
- Development of further links with Industry to support research funding
- Evaluation of psychological needs of OFP patients and identify best practise in management
Long term goals
- Establishing the research team as national and international lead in trigeminal pain Establishing the research team as national and international lead in the prevention and management of trigeminal nerve injuries
- Leading centre in pharma trials for analgesics and anxiolytics