General dental practitioners and community dental officers may need to consider several factors when referring patients to the consultant orthodontic service. In Birmingham, a local professional group incorporating representatives from both primary care and secondary care (consultant) services have drawn up a set of formal referral guidelines. The purpose of the exercise was to encourage the most appropriate use of the consultant service so that its resources could be directed towards those in greatest need. In this paper, the factors which determine the patients requiring referral are discussed; a second article will deal with the actual process of referral.

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