The use of inhalation sedation and local anaesthesia as an alternative to general anaesthesia for dental extractions in children.
OBJECTIVE
To determine the extent to which inhalation sedation might replace general anaesthesia for extractions in children and assess the success rate, cost and parental reaction in comparison to general anaesthesia.


METHODS
A matched pair design.


METHODS
Unit of paediatric Dentistry at the University Dental Hospital of Manchester, UK between December 1992 and June 1994.


METHODS
Subjects aged 3 to 16 years who had been referred for extractions under general anaesthesia were used. Data were recorded for each visit and parents were asked to complete a simple post-operative questionnaire.


RESULTS
Treatment success was defined as completion of all treatment planned for the patient. Relative costs were derived from the time taken and staff costs.


RESULTS
265 subjects, mean age 7.63 (+/- 2.45) years had treatment attempted with sedation of whom 221 (83.4%) completed successfully. Young age, multiple extractions and irregular dental attendance predisposed to treatment failure, whereas orthodontic extractions had a similar success rate (97.6%) to general anaesthesia. The cost of sedation was less; parental reaction to sedation was also significantly better.


CONCLUSIONS
Inhalation sedation can be used for many children referred for general anaesthesia. Greater use of this technique in the primary sector is needed to reduce the number of child referrals for general anaesthesia.
Unit of Paediatric Dentistry, University Dental Hospital of Manchester.
K M
KM
Blain
F J
FJ
Hill
D000293:Adolescent; D000766:Anesthesia, Dental / Q000191:economics / Q000379:methods*; D000768:Anesthesia, General / Q000191:economics / Q000379:methods; D000769:Anesthesia, Inhalation / Q000191:economics; D000772:Anesthesia, Local / Q000191:economics / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D019140:Dental Care for Children; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D011795:Surveys and Questionnaires; D014081:Tooth Extraction