Intermediate Minor Oral Surgery

The provision of the Intermediate Minor Oral Surgery Service (IMOS) has transferred to the Community Dental Service (CDS), as part of Gloucester Health and Care NHS Foundation Trust (GHC NHSFT).

IMOS is a referral service for patients requiring Level 2 care – i.e. care provision from a clinician with enhanced skills and experience on a specialist level.

The IMOS provides Level 2 oral surgery procedures which are beyond the scope of mandatory services, as defined by NHS GDS contract and PDS agreement regulations.

The referral criteria includes:

Level 2 oral surgery procedures for patients (adult-18 years old) that have demonstrated they are able to accept dental care in general dental services. However, it is the complexity of the minor oral surgical procedure that is the reason for the referral.

This excludes:

• Patients unable to accept treatment under local anaesthetic alone due to dental anxiety – for example, requiring treatment under sedation or general anaesthetic
• Children (under 18 years of age)
• Patients with special care needs who are unable to accept treatment under local anaesthetic alone (please consider referral to the Special Care Dental Service).

Minor oral surgery procedures:

• Surgical removal of uncomplicated third molars involving bone removal, excluding third molars that appear to have signs of intimacy with the corresponding Inferior Dental Canal on plain film radiography, as we do not have access to three-dimensional imaging
• Surgical removal of buried roots and fractured or residual root fragments
• Exposure of palpable or superficial impacted teeth/removal of teeth for orthodontic treatment if the patient is over 18 years of age.

Patients referred have been assessed as ASA I and ASA II (using the American Society of Anaesthesiologist physical status classification system), with no significant medical history that cannot be managed in general dental services.

This includes patients on oral antiresorptive medications and patients taking anticoagulant and antiplatelet medications. Please provide details of the medications, frequency of therapy, indication for therapy and the duration of therapy.

We are unable to accepts referrals for treatment requiring access to histopathological diagnostic services, this includes incisional and excisions biopsies, apicectomies, cyst enucleation.

We do not have facilities for facial reconstruction plate and screw removal.

Referrals will be accepted using the IMOS e-referral form only (see below). Please note, this form is different from the Special Care/Paediatric e-referral form.

E-referrals will be triaged by the IMOS Performer and a decision will be made on whether or not the patient meets the acceptance criteria for the service.

Where the e-referral does not meet the criteria, it will be returned electronically to the referrer with appropriate feedback.