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GPs say dentist dispute will swamp surgeries

By Daniel Cressey

GP leaders have warned surgeries will be swamped with oral health problems if dentists continue to opt out of the NHS in protest at their new contracts.

GPs fear patients unable to afford private dental care will be forced to seek free treatment at their doctor's practice.

The GPC advised GPs to refuse to do dental work and to refer it to the PCT.

It said it broadly supported a motion by Manchester LMC, to be presented to the LMC conference in June, condemning the new dental contract as 'detrimental to patient care', as 'it relies on GPs continuing to see dental problems'.

Dr Tracey Vell, vice-chair of Manchester LMC, said: 'I do feel increasingly GPs are picking up the work of other NHS areas.'

Dr Andrew Dearden, GPC negotiator and a GP in Cardiff, said: 'I would certainly agree with the feeling behind the motion. The dental contract was supposed to attract in NHS dentists ­ obviously the Government has not made it attractive enough.'

He said GPs should refer on dental problems. 'If you need a plumber and one isn't available you don't go to an electrician.'

Medicolegal experts said GPs should not stray beyond the limits of their expertise and advised that under the dental contract PCTs would be legally responsible for oral care.

Dr Stephanie Bown, director of education and communications at the Medical Protection Society, said: 'With the changes to the dentists' contract I fully understand GPs may have a concern the magnitude [of oral problems] may become greater.

'Under the new contract the PCT has responsibility for a patient's dental care. Once the GP has made sufficient assessment to be confident it's a dental problem he or she is under an obligation to direct that patient either to the PCT or dental services.'

Mr Peter Dyer, consultant in oral and maxillofacial surgery at Royal Lancaster Infirmary, said: 'The pointers for the GP are dental pain and dental swelling in the mouth. The other area is bleeding ­ which normally occurs after dental extraction. That really ought to be referred to dental centres.'

Conditions that might need urgent referral

· Dental abscess with spreading facial cellulitis

· Facial fractures

· Uncontrolled trigeminal neuralgia

· Post extraction bleeding

· Suspected oral malignancy

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