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Dental Surgeons of Ontario
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Requesting Magnetic Resonance Imaging & Referring to Physician Specialists by Oral and Maxillofacial Surgeons

Approved by Council November 2019
Published by the College March 2022

An oral and maxillofacial surgeon may require advanced diagnostic imaging to accurately assess and diagnose a patient’s disease, disorder or dysfunction of the oral-facial complex. In such instances, MRI can generate outstanding soft tissue contrast to differentiate between normal and abnormal tissues. An oral and maxillofacial surgeon may also need to refer to a physician specialist to assist in the management of the patient’s condition.  

NOTE: The following section on Requesting Magnetic Resonance Imaging will come into force on July 1, 2022.

Requesting Magnetic Resonance Imaging  

The primary indications for an oral and maxillofacial surgeon to request MRI include evaluation and assessment of tissues of the head and neck for temporomandibular disorders, cysts, neoplasms and other tumour-like conditions, neurogenic diseases, and infections. 

The drawbacks of MRI include insensitivity to calcification, as well as degradation of images caused by motion artifacts (e.g., swallowing or respiratory movements) or the presence of ferromagnetic materials (e.g. stainless steel).

Any dentist who has completed a formal graduate or post- graduate program in oral and maxillofacial surgery, and who holds a specialty certificate of registration as an oral and maxillofacial surgeon in the Province of Ontario, should possess the knowledge, skills and judgement to determine when it is appropriate to request MRI.  

When requesting MRI, an oral and maxillofacial surgeon must:  

  • Provide the patient with written information about MRI procedures prior to an appointment.  
  • Complete an MRI requisition form, providing:  
    • basic demographic information of the patient, such as name, health card number, date of birth and sex  
    • name of the requesting oral and maxillofacial surgeon and the names of any other healthcare providers who are to receive copies of the report 
    • pertinent clinical information, including history of the patient’s condition, results of previous imaging studies and provisional diagnosis  
    • imaging region of interest requested 
    • any other information that would assist the medical radiologist in the assessment of the imaging request 
    • whether an “expedited report” is required.  
        • Complete the MRI screening form.   
        • Ensure there is an appropriate process to receive, review and act on the report.  
          The requesting oral and maxillofacial surgeon is responsible for clinical follow-up and shares the responsibility of obtaining the results of imaging studies they have requested.  
        • Ensure there is an appropriate process to communicate unusual, unexpected or urgent findings to an alternative provider in circumstances such as holidays, sickness or restricted office hours.  
        • Keep documentation of the referral request, as well as the consultation report received.  

        NOTE: The following section on Referring to Physician Specialists is not in force. It will come into force when the Ontario Government has made the changes necessary for that to happen.

        Referring to Physician Specialists  

        An oral and maxillofacial surgeon may wish to refer to a physician specialist if:  

        • the patient’s condition extends beyond the scope of oral and maxillofacial surgical practice 
        • the patient presents with a co-morbid condition 
          (e.g., cardiovascular disease, diabetes, endocrine or neurologic disorder) that requires inter-professional collaboration for medical management in the context of oral and maxillofacial treatment.  

        Any dentist who has completed a formal graduate or post-graduate program in oral and maxillofacial surgery, and who holds a specialty certificate of registration as an oral and maxillofacial surgeon in the Province of Ontario, should possess the knowledge, skills and judgement to determine when it is appropriate to refer to a physician specialist.  

        When referring to a physician specialist, an oral and maxillofacial surgeon must:  

        • Inform the patient of the reasons for the referral, and the expected nature and scope of the referral.  
        • Complete a physician specialist referral form or letter, providing:
          • basic demographic information of the patient, such as name, health card number, date of birth and sex 
          • name of the referring oral and maxillofacial surgeon and the names of any other healthcare providers who are to receive copies of the report 
          • reasons for the referral, including clear instructions on the nature and scope of the referral 
          • pertinent clinical information, including history of the patient’s condition, results of previous imaging studies, relevant laboratory reports or specialist reports, provisional diagnosis and, when indicated, the proposed oral and maxillofacial treatment 
          • any other information that would assist the physician specialist in the assessment of the patient 
          • whether an urgent consultation is required.  
            • Ensure there is an appropriate process to receive, review and act on the report . The requesting oral and maxillofacial surgeon is responsible for clinical follow-up, including obtaining the physician specialist’s report.   
            • Ensure there is an appropriate process for the communication of unusual, unexpected or urgent findings to an alternative provider in circumstances such as holidays, sickness or restricted office hours.   
            • Keep documentation of the referral request, as well as the consultation report received.  

            For a listing of sites where MRI services are offered and wait times, visit the Ontario Health website.