EditorNHS DENTISTRY: Nine-year-old waited two years for treatment — then was seen within days after dentist used rapid advice service
A nine-year-old girl in west Wales waited nearly two years for orthodontic treatment after her referral was rejected — only to be seen within days once her dentist used a rapid specialist advice service to break through the delays.
The case, in the same week that Wales’s biggest dental shake-up in a generation came into force, illustrates the pressure already building across the NHS in west Wales — with dentists warning that long referral times are causing children to miss critical treatment windows.
Dr Christina Evans, a dentist in the Hywel Dda University Health Board area, described the case of a patient whose condition had been deteriorating while she waited for specialist care. The original referral had been rejected with advice to wait until the child had more permanent teeth. By the time Dr Evans saw her again, the situation had worsened significantly.
Dr Evans said she had not known what to do when the girl’s condition continued to deteriorate. “I had originally referred her nearly two years ago — but the referral was rejected with the comment: ‘Wait until the patient has more permanent teeth.’ More recently, I saw her again, and her condition was deteriorating. She was growing more, and the skeletal pattern was getting worse. I didn’t know what to do,” she said.
Concerned about missing the optimal window for treatment, Dr Evans turned to Consultant Connect — a telemedicine service that gives clinicians rapid access to specialist advice — and contacted an orthodontic specialist at Morriston Hospital directly.
She said: “I explained the situation and that I was worried about missing the window of opportunity for treatment.” The consultant responded immediately, advising that a referral would now be appropriate. Dr Evans submitted the referral and said: “The patient’s family received a call approximately two days after I sent the referral to make an appointment.”
She said the service had transformed her ability to act quickly for patients. “The advantage of Consultant Connect is that you can receive a response quickly, so you don’t need to delay treatment while waiting for a referral response. You can move forward confidently and treat the patient appropriately without unnecessary delay,” she said.
Across the Hywel Dda area, 74% of cases using the service avoid a hospital visit entirely — freeing up capacity in the system while getting patients the advice they need faster.
The case comes as NHS dentistry in Wales faces a period of significant upheaval. From this week, the Welsh Government’s new dental contract has come into force, bringing higher patient charges, longer intervals between check-ups, and warnings from dentists that the reforms risk pushing more practices out of the NHS altogether. Critics have argued the changes will make it harder, not easier, for patients to access timely care.
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