A survey of referral patterns to a paediatric dentistry unit over a 2-year period.

Following the changes in October 1990 in the payment system for children's dental treatment within the General Dental Service in the UK there has been widespread concern that repercussions would be felt in other branches of dentistry. The aim of this survey was to investigate the referral of children for specialist care to the Department of Child Dental Health in Newcastle upon Tyne after the changes in 1990, so that consultant clinics and the provision of advice and treatment could be targeted more effectively. Information was obtained from the patients' referral letters and from their hospital records between March 1991 and March 1993. There were 513 referrals (excluding those for orthodontic treatment, extractions under general anaesthesia and acute emergencies), the number more than doubling during the 2-year survey period. 83% of these patients lived within 15 miles of the hospital. 84% of these referrals were from general dental practitioners, and the greater proportion were from those who graduated within the previous 4 years. The most common reason for referral involved behaviour problems. Changes in the payment system that occurred in 1990 may have been a contributory factor in explaining these findings.