2. How fast — routine, urgent, emergency, suspected cancer

Not everything is two-week wait

Urgent suspected-cancer pathways exist so true red-flag lesions are seen quickly. Overusing them blocks the patients who need them. Underusing them misses cancers. Oral Cancer: Early Detection covers the clinical red flags. This lesson is the administrative duty: if the criteria are met, refer on that pathway the same day you decide, not after a fortnight of “watching it.”

Emergency

Uncontrolled bleeding, rapidly spreading infection with systemic upset, airway risk, and some facial trauma belong in emergency care — 999 or the local urgent dental / maxillofacial arrangement — not a routine consultant letter. Do not send a septic patient home with “see your GMP next week” as your only plan.

Urgent but not cancer

Severe pain, spreading infection without airway threat, and some trauma still need a same-week or local urgent dental pathway. Know what your area actually offers after 17:00 and at weekends.

Routine

Most orthodontic opinions, non-urgent oral medicine, and elective oral surgery sit here. Tell the patient a realistic wait. A referral is not an anaesthetic.

Safety net

Until the other service has accepted the patient, they are still yours for advice, analgesia, and what to do if it worsens. “I have referred you” is not the end of the conversation.