Dentistry · Referral letter · Intermediate

Dentistry — Referral to Oral Surgery for an Impacted Wisdom Tooth

A dentist refers a 24-year-old with a recurrently infected, impacted lower wisdom tooth to an oral and maxillofacial surgeon for removal. The case tests dental-specific selection: the radiographic findings and infection history matter; the unrelated dental history does not.

Letter type

Referral

Write to

Oral and Maxillofacial Surgeon

Target length

180–200 words

The case notes

Patient: Mr Liam Foster, 24 years old, student

Presenting complaint: Three episodes of pain and swelling around the lower left wisdom tooth in 6 months

Examination: Partially erupted lower left third molar; overlying gum inflamed (pericoronitis); tender, limited mouth opening during episodes

Radiograph: OPG: mesioangular impaction of lower left third molar; close relationship to the inferior alveolar nerve canal

Treatment to date: Two courses of antibiotics and oral hygiene measures; symptoms recur

Medical history: Fit and well; no allergies; non-smoker

Dental history: Otherwise good oral health; regular attender; no other active disease

Task: Write a referral letter to Mr Awan, Oral and Maxillofacial Surgeon, requesting assessment for surgical removal of the impacted tooth.

Writing task

Write a referral letter to Mr Awan, Oral and Maxillofacial Surgeon, requesting assessment for surgical removal of the impacted tooth.

What to include, what to cut

The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.

Include

  • Recurrent pericoronitis and the number of episodes

    The recurrence is the clinical justification for surgical referral rather than continued conservative care.

  • The radiographic impaction and proximity to the nerve

    Decision-critical: it shapes the surgical risk assessment and consent the recipient must plan for.

  • Failed antibiotics and hygiene measures

    Shows conservative management has been exhausted, which is the reason for escalation.

Leave out

  • General good oral health and regular attendance

    Reassuring but not decision-relevant to the extraction; a brief mention at most, not a paragraph.

  • Student status

    Background colour with no bearing on the surgical referral.

Criterion in focus · Content

Dental referrals are graded on whether you select the findings that justify surgery — the recurrence and the radiographic relationship to the nerve. Omitting the nerve proximity, or padding with unrelated dental history, both cost Content marks.

Now write the letter — and find out what is blocking your Grade B

Write a 180–200 words referral letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.

Questions about this case note

What do OET case notes look like for dentists?
They mirror the standard format — patient details, presenting complaint, examination, radiographs, treatment to date, and a task — but the clinical content is dental: caries, periodontal status, impactions, radiographic findings and referrals to oral surgery or specialists.
What justifies a surgical referral in a dental OET letter?
Show that conservative management has failed and that there is a clear clinical reason to escalate. Here, recurrent infection plus a radiographically confirmed impaction near the nerve justifies surgical assessment, and those are the facts to lead with.

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