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.
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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.