We will assess all patients in a standard way using an assessment checklist. Patients are given a medical history questionnaire (MH) to complete while in the waiting room. All patient documentation including the MH form is checked initially by the reception staff.

• Using the referral form and from clinical findings, the examining dentist assesses level of anxiety, previous dental experiences and current dental needs prior to formulating an appropriate treatment plan.

• We give detailed and comprehensive advice and instructions to patients and carers, ensuring that they are fully informed and are able to consent to the proposed treatment plan (including anxiety management). Each patient is given a clear explanation of the options available and their associated risks.

An assessment checklist is filled in for each referred patient and kept with the notes. Ideally the referring dentist will have supplied us with radiographs and other records relevant to the assessment.

Colleagues should appreciate that the choice of anxiety management technique may modify the dental treatment plan. We encourage referring dentists to indicate (by ticking the box on the referral form) that they are happy for QAMC to undertake any necessary dental treatment to secure oral health in the context of the anxiety management technique adopted.

In the event that the appropriate box on the referral form is not ticked and there is a discrepancy between treatment requested on the referral form and that found to be indicated, every attempt will be made to contact the referring dentist. Where this proves to be impossible, another dentist in QAMC will be asked to give a second opinion and the majority decision incorporated into the plan. This decision will be noted on the patient records.

Action - Please ensure all relevant records (e.g. radiographs, copy of specialist orthodontic referral letter) are sent with the referral form or accompany the patient to the assessment appointment.

Action - Please advise patients to bring all medications with them to the assessment appointment.

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