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What Physicians Really Know About Dentistry

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Categories: Practice Management, HR and Accounting;
What Physicians Really Know About Dentistry

Why dentists must lead on oral-systemic referrals

Physicians receive very limited dental training, usually just a few hours during medical school, and most will openly admit they’re not competent in diagnosing or managing dental conditions. Their understanding tends to be limited to recognizing oral signs of systemic illness, anatomy, or emergency airway risks. Dental issues are often overlooked or dismissed unless they lead to severe complications like deep neck infections, sepsis, or airway compromise.

That said, some physicians, especially those in infectious disease, ENT, or radiology, are increasingly aware of how serious dental infections can become. A few shared stories of missed dental abscesses that turned into life-threatening emergencies, only caught after exhaustive and expensive workups failed to reveal the source. Others noted that patients often present with reactive cervical lymphadenopathy or vague systemic symptoms where the dental origin goes unnoticed.

Many physicians joked about how little they retain from oral health lectures and how dental pain or pathology is something they either ignore, refer offhandedly, or make light of, until it turns into a full-blown ICU admission. Radiologists and ENTs are often left to clean up the diagnostic mess and emphasize the need for proper imaging protocols (soft tissue neck CTs, not CTA) to evaluate for odontogenic sources.

Dentists looking to build physician referrals for TMD or oral appliance therapy (OAT) need more than a one-time letter or call. A consistent, value-driven communication strategy is essential. Sending updates on patient progress, especially after referrals, helps build trust and keeps referrals coming.

ENTs are the most likely to refer TMD patients, especially when symptoms like tinnitus or ear pain have no clear otologic source. Sleep physicians are also key partners, though some remain hesitant or unclear on the division of roles. Dentists must clearly communicate that oral appliances must be prescribed by a physician per Medicare and other payer guidelines, and the dentist’s role is to evaluate candidacy, not to prescribe.

Primary care doctors can also be solid referral sources because of their whole-patient focus. Still, the most consistent source of TMD referrals may be other general dentists who prefer not to manage complex TMD cases themselves.

Marketing to physicians requires effort. Some dentists recommend bringing lunch, educational materials, appliance samples, and pre-filled referral forms to busy practices. Anything that simplifies the referral process and highlights efficacy helps. However, frustration is common; many physicians are poorly trained in dental sleep medicine, and some are entrenched in CPAP-only models, especially when they have financial ties to DME suppliers.

Dentists should expect slow growth in referral volume unless they deeply commit to education, relationship-building, and developing collaborative, non-competitive models of care centered on patient outcomes. Without that sustained effort, referrals will likely remain sporadic.

Key takeaway for dentists: When working with medical colleagues, assume minimal dental knowledge. Be clear, concise, and proactive when communicating about oral infections or complications. Offer to help educate referring providers on when to refer dental cases, what to watch for in systemic symptoms, and how serious dental pathology can get. Dentists should also understand that if they don’t step up to manage these infections early, patients may fall through the cracks, or land in the ICU with devastating, preventable outcomes.

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