A baseline study of referrals by letter to a department of conservative dentistry staffed purely by honorary consultants was conducted for one year. Distinct differences were found between the majority of patients referred from general practice and those referred from other sources. Principal reasons for referral were problems of tooth replacement, appearance, endodontics and tooth wear. A predominance of female patients was seen in all groups except those complaining of tooth wear. 'Endodontic' patients featured the highest proportion of requests for hospital treatment. Complex restorative treatment was provided for the majority (70%) of referred patients, and about 10% received treatment from dental students. The rates of referral showed evidence of dependence on travelling distance to the referral centre but not on the availability of local GDPs. This emphasises the importance of maintaining existing specialist dental referral services in major population centres and the development of new services where appropriate.