Dental evaluation prior to medical treatment: who to refer?

British Journal of General Practice, January 2015 e58 IntroDuCtIon Oral health is entwined with general health. Recent research has indicated possible associations between chronic oral infections and diabetes, heart disease, lung disease, and stroke.1 Oral health is more than clean teeth; it involves the gums and their supporting tissues, jawbones, oral mucosae, tongue, masticatory muscles, and salivary glands. Dental caries and periodontal disease, which are frequently silent, are the two leading causes of poor oral health. They are among the most common chronic diseases in the UK. The relationship between poor oral health and medical treatment is complex. Some medical treatments exacerbate oral disease; oral disease can in turn jeopardise medical treatment and systemic health. Dental evaluation prior to medical treatment became accepted practice many years ago with regard to patients about to undergo radiation therapy for head and neck cancers. We highlight four groups of patients about to commence specific treatments that should be referred to a dentist prior to this treatment: