The single-line answer
No. We treat the specialist work; we return the patient to you for everything else.
The rest of this page is the operational detail of how that works in practice — and the explicit list of things we do not do.
What counts as the "specialist work" you keep?
Specialist work is the periodontal and oral-medicine treatment that sits inside our scope and outside general-practice scope. These are the cases we keep through the entire treatment phase:
- Active periodontitis treatment — non-surgical periodontal therapy, surgical phases, and the re-evaluation at the end of treatment.
- Implant placement — including the surgical visit, the temporary restoration where applicable, and the surgical follow-up. The final restorative crown or bridge is placed by you or by a prosthodontist.
- Gum graft surgery and other periodontal plastic procedures.
- Soft-tissue biopsy with histopathological diagnosis and any subsequent management of mucosal disease.
- Crown-lengthening and other periodontal surgery preparatory to restorative work.
Once the specialist treatment phase is complete, the patient is returned to you. We send a treatment-completion summary explaining what was done, the post-treatment status, and what we recommend you monitor at your routine recalls.
What will you not do on my patient?
Restorative dentistry and routine care belong with you, not with us. Specifically:
| Treatment | Stays with you |
|---|---|
| Routine 6-monthly check-ups | Yes |
| Fillings of any kind | Yes |
| Crowns and bridges | Yes |
| Root canal treatment | Yes |
| Routine scaling and polishing (for patients without periodontitis history) | Yes |
| Tooth whitening | Yes |
| General oral hygiene instruction at routine visits | Yes |
| Removable denture work | Yes |
| Routine paediatric dentistry | Yes |
| Restorative work on top of implants (final crowns, bridges, attachments) | Yes |
We do not solicit the patient for any of these. We do not market routine dental services to our specialist patients. We do not contact them between specialist visits with offers, recall reminders for routine care, or anything that could be construed as competing with your relationship.
Which patients do you keep seeing afterwards, and how often?
A subset of cases benefit from continuing specialist involvement after the active treatment phase. In these cases, the specialist follow-up happens alongside your routine care, not in place of it, and the recall interval is set by the patient's risk rather than by a fixed rule:
Periodontal maintenance after periodontitis treatment
Periodontal maintenance is professional mechanical plaque removal plus re-charting, repeated at a planned interval to keep treated periodontitis stable. The interval is individualised rather than fixed: a 3-to-4-month recall is reasonable for moderate-to-advanced cases, but lower-risk patients may be safely seen less often, and the schedule is set by risk, not by a single rule (Trombelli et al., recurrence-of-periodontitis review). What is consistent in the evidence is that regular professional maintenance limits further tooth and attachment loss in treated periodontitis patients. This visit is the work that determines whether the active-treatment result holds. Your routine check-ups continue at the cadence you set.
Surveillance of potentially malignant lesions
A patient with lichen planus, leukoplakia, or another oral potentially malignant disorder needs periodic specialist examination of the lesion, and the interval is stratified by risk rather than fixed. Higher-risk lesions (non-homogeneous leukoplakia, erosive or atrophic lichen planus, lesions on the tongue or floor of mouth, or a patient who smokes) are reviewed more often — typically every 3 to 6 months — while a long-standing, stable, low-risk lesion may be reviewed every 6 to 12 months. The interval is set lesion-by-lesion at each visit. Your routine dental care continues separately.
Implant follow-up
Dental implants benefit from supportive peri-implant therapy — periodic specialist review of the peri-implant tissues with professional cleaning — and the recall is individualised rather than annual by default. For most implant patients a maintenance interval of around 6 months or shorter is the usual recommendation, tightening to roughly 3 to 4 months in the first year for patients treated for peri-implantitis or at higher risk; a once-a-year review is at the longer, lower-risk end (supportive peri-implant therapy review). The interval is set around the patient's risk and scheduled to fit with their general visits. Your routine work on the patient (and on the restoration on top of the implant, where you placed it) continues.
In each case, we tell the patient explicitly that they keep their general dentist for everything else. We tell you explicitly, in the treatment-completion summary, what the specialist recall pathway looks like — so there is no ambiguity about who is doing what.
How this works in the rare cases where the patient asks us to take over
Patients sometimes ask, during a specialist visit, whether we can do their routine work too — because they like the practice, because the location is convenient, because they want to consolidate. The answer is no, with an explanation. We explain that:
- Restorative and routine dental care is general-practice scope, not specialist scope.
- Their existing dental relationship is valuable and we do not want to disrupt it.
- If they have a specific concern about their general dentist, that is a separate conversation they should have with their dentist.
In the small number of cases where the patient explicitly tells us they no longer have a general dentist (because they have moved, or because their previous dentist has retired), we suggest practices in their area where we have a professional relationship — and we make clear that we are not part of the referral.
Why do you hold to this boundary?
Two reasons, in order of importance:
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It is professionally correct. Under the dentist annexure to the HPCSA Ethical Rules of Conduct, a dentist or dental specialist "shall perform professional acts only in the field of dentistry in which he or she was educated and trained and in which he or she has gained experience," and "shall not fail to communicate and cooperate with dentists, dental specialists and other health practitioners in the diagnosis and treatment of a patient" (HPCSA Ethical Rules of Conduct, dentist annexure rule 2(a)–(b); general Rule 21).1 Confining ourselves to specialist scope and cooperating with you are therefore professional obligations. Returning the patient to you for routine care goes a step beyond those rules — there is no codified HPCSA rule that requires it — so we treat it as the professional norm of a referral practice and as our own practice policy, not as a regulation we are quoting.
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It is good for our practice. Our practice depends on the continuing trust of the referring general dentists in our area. If we were known for absorbing patients, the referrals would dry up — and they should. Maintaining the boundary is not an act of generosity; it is the structural basis of a referral practice working properly.
We do not expect a thank-you for following these principles. They are the baseline of what a specialist owes a referring dentist.
What you can expect when you refer
To restate:
- We see your patient promptly.
- We do the specialist work.
- We send you a written report.
- We send your patient back to you.
- If ongoing specialist follow-up is warranted, we do it in parallel with your routine care.
- We are available by phone or email for any questions during or after the case.
If you observe a deviation from any of these, please tell us — directly. We treat that feedback as central to how we improve.
This article is general educational content describing our practice's referral relationship with general dentists. Specific arrangements for individual cases are agreed in conversation.