Maxillofacial Referral Patterns from Public Oral Health Facilities in Gauteng

Public oral health (POH) facilities in Gauteng are not adequately staffed and equipped to be able to treat maxillofacial cases. As a result, most of these patients are referred to regional and tertiary dental hospitals. Objective: To determine the number of patients being referred and the type of treatment required from each district in Gauteng. Methods: This was a retrospective record based study from 2nd January 2009 to 31st July 2009. The referral hospital, patient numbers and type of treatment needed was obtained from the POHC facilities in Gauteng. Results: Of the total 318 249 patients who attended POH facilities over the study period, 2 913 (0.9%) were referred. Almost half of all referrals (49%) were from the Johannesburg Metro (JM) region. Patients were referred to the Universities of Witwatersrand (41%), Pretoria (19%) and Chris Hani Baragwanath (CHB) Hospital (21%). Patients from West Rand and Sedibeng regions were referred to Yusuf Dadoo and Sebokeng hospitals, even though there were no specialised maxillofacial services available (2% and 7% respectively). Patients were referred for dental impactions (76%), pathological lesions (13%) and fractures (11%). Conclusion: The JM region referred most patients and the dental schools together with the CHB Hospital received most referrals. The Sedibeng and West Rand regions referred their patients to secondary hospitals. Staff at secondary and centrally located POHC facilities could be trained to treat simple conditions which could reduce the burden on tertiary dental hospitals.