The task
Assume that today's date is 22 October 2026. Felicity attended for review with her mother last week.
You are Dr Victoria Greenhalgh, a general dental practitioner. Felicity Pickering has been a patient at your practice for several years. Using the information in the case notes, write a letter of referral to Dr Omar Mansour, Specialist Orthodontist, requesting assessment and treatment planning for Felicity. Address the letter to Dr Omar Mansour, Specialist Orthodontist, Specialist Orthodontic Practice, Suite 4, 210 Harbour Road. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Referral letter.
Case notes
Patient details
- Name: Miss Felicity Pickering
- DOB: 03/05/2014 (12 yrs)
- Address: 14 Elm Street
- Pt of practice since 2018; attends 6/12 recalls regularly
Social background
- Lives with mother; mother attends all appts
- Plays hockey (school team) and netball weekly
- Enjoys horse riding at weekends
- Parents separated 2023; father lives interstate — mother asked that this not be discussed
- F self-conscious about 'sticking-out' front teeth; some teasing at school
- Mother complained that receptionist was rude about rescheduling appt
Medical history
- Mild asthma — daily low-dose ICS preventer + salbutamol inhaler PRN (managed by GP); no hospital admissions
- Allergies: NKDA
- Tonsillectomy age 6
- Thumb-sucking until age 7; ceased
Dental history
- Caries-free; fissure sealants 16, 26, 36, 46 (2022)
- OH good — brushes BD with fluoride toothpaste; minimal plaque; gingivae healthy
- Elder brother had ortho Tx at another practice — mother 'very unhappy' with result
- 18/09/26: struck by hockey ball → enamel-dentine fracture 21 (mesio-incisal)
- Composite restoration 21 same day; no mobility or displacement; sensibility tests +ve; PA radiograph NAD
- Review 16/10/26: 21 asymptomatic; cold test +ve
Clinical examination (16/10/26)
- Early permanent dentition; 17, 27 erupting
- Class II div 1 incisor relationship; overjet 9 mm
- Lips incompetent at rest; upper central incisors proclined
- Molars Class II bilaterally
- Overbite ↑, complete; no palatal impingement
- Mild crowding lower labial segment; centrelines coincident
- No crossbites; no TMJ symptoms
- Convex profile; retrusive mandible
Investigations
- OPG 16/10/26: all permanent teeth present incl. developing third molars; no pathology; no ectopic teeth
- Intra- and extra-oral photographs taken — copies (with OPG) to send to orthodontist
Discussion
- Explained ↑ risk of incisor trauma with large overjet; mouthguard advised for all contact sport
- Custom mouthguard fitted 02/10/26 — wears for hockey; reluctant to wear for netball
- F and mother very motivated; understand Tx may involve appliances and long-term retention
- Mother asked about costs and payment plans
Plan
- Refer to specialist orthodontist for assessment and Tx planning
- Trauma reviews 21 (separate from routine recalls): 6–8/52 post-injury (by 13/11/26) and 1 yr (09/27) — clinical exam, sensibility tests, PA radiograph. Continue routine 6/12 recalls with GDP; OH and fluoride reinforcement
Who is reading, and what do they need?
Dr Mansour is a specialist orthodontist who does not know Felicity. He needs the occlusal findings, relevant medical and dental history, the recent incisor injury and what is enclosed. He will carry out his own full assessment, so the letter needs a focused clinical picture, not a complete history.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Class II div 1 incisor relationship; overjet 9 mm | This is the core finding behind the request for assessment and treatment planning, so it should be stated precisely. |
| Lips incompetent at rest; upper central incisors proclined | Describes the soft-tissue and incisor position that goes with the large overjet; the specialist needs it to judge the case. |
| Molars Class II bilaterally; overbite increased, complete; mild lower crowding; convex profile, retrusive mandible | Completes the occlusal picture; these can be grouped briefly with the negative findings (no crossbites, no TMJ symptoms, coincident centrelines). |
| 18/09/26 hockey ball injury; enamel-dentine fracture 21, composite placed, tests positive | A recent traumatised and restored incisor is directly relevant to planning, and the review outcome (asymptomatic, cold test positive) shows its current state. |
| OPG 16/10/26 and photographs, copies to be sent | The orthodontist needs to know the OPG findings (all permanent teeth present, no pathology, none ectopic) and that images are enclosed. |
| Custom mouthguard worn for hockey; reluctant for netball | Links the increased trauma risk to what has been advised and what is actually being done in contact sport. |
| Mild asthma on daily low-dose ICS plus salbutamol PRN; NKDA; thumb-sucking until 7 | Relevant medical and habit history for a specialist who will plan appliances; allergy status should be stated. |
| Caries-free, good OH; patient and mother very motivated; understand appliances and long-term retention | Supports suitability for treatment and shows expectations have been discussed. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Parents separated 2023; mother asked that father not be discussed | An explicit request for non-disclosure, and no clinical bearing on this referral. |
| Mother complained about receptionist being rude | A practice-management complaint, not a clinical matter for the specialist. |
| Elder brother's ortho treatment elsewhere; mother 'very unhappy' | Trap: it seems to bear on expectations, but it concerns another person's care at another practice and is not Felicity's history. |
| Tonsillectomy at age 6 | No stated bearing on this referral; the relevant medical history is the asthma. |
| Horse riding; mother asked about costs and payment plans | Horse riding is not part of the injury history, and fees are a matter for the orthodontic practice. |
| Detailed 21 trauma review schedule | The GDP is managing these reviews; compress to a brief statement of who is responsible and the planned reviews rather than a full list. |
A paragraph plan for this case
Open with the request and Felicity's age, then give the occlusal findings and relevant medical and dental history in a second paragraph. Finish with the 21 injury and its follow-up, mouthguard use, motivation and enclosed images.
Where candidates slip on this task
- The 21 trauma reviews (by 13/11/26 and at 1 year, 09/27) remain with the GDP and are separate from routine recalls; make clear who is doing them, not that the orthodontist must.
- Word the netball mouthguard issue accurately: worn for hockey, reluctant for netball. Do not say she refuses, and do not drop the hockey detail.
- Keep orthodontic terms exact (overjet 9 mm, Class II division 1, proclined) and expand abbreviations such as ICS into full words.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
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Your profession's guide: OET Dentistry. Layout and structure: OET letter format.
Questions about this task
Should I mention the family situation or the mother's complaint?
No. The mother asked that the father not be discussed, and the complaint about reception is administrative. Neither helps the orthodontist assess Felicity, and they would use up limited words.
Why include the fractured incisor if the referral is for overjet?
The tooth was injured and restored recently, and the large overjet is linked to trauma risk in the notes. The specialist should know its current status, and that further reviews are pending, without treating the outcome as final.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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