General dental practitioner's views on dental general anaesthesia services.
OBJECTIVE
Policy has recently changed on provision of dental general anaesthetic services in England. The aim of this study was to investigate general dental practitioners' views about dental general anaesthetics, the reduction in its availability and the impact on care of children with toothache.


METHODS
Qualitative study using semi-structured interviews and clinical case scenarios.


METHODS
General dental practitioners providing NHS services in the North West of England.


RESULTS
93 general dental practitioners were interviewed and 91 answered a clinical case scenario about the care they would provide for a 7-year-old child with multiple decayed teeth presenting with toothache. Scenario responses showed variation; 8% would immediately refer for general anaesthesia, 25% would initially prescribe antibiotics, but the majority would attempt to either restore or extract the tooth causing pain. Interview responses also demonstrated variation in care, however most dentists agree general anaesthesia has a role for nervous children but only refer as a last resort. The responses indicated an increase in inequalities, and that access to services did not match population needs, leaving some children waiting in pain.


CONCLUSIONS
Most general dental practitioners support moving dental general anaesthesia into hospitals but some believe that it has widened health inequalities and there is also a problem associated with variation in treatment provision. Additional general anaesthetic services in some areas with high levels of tooth decay are needed and evidence based guidelines about caring for children with toothache are required.
Threlfall
A G
AG
Oral Health Unit, National Primary Care R&D Centre, Manchester University Dental School, Higher Cambridge Street, Manchester.
King
D
D
Milsom
K M
KM
Blinkhom
A S
AS
Tickle
M
M
D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002648:Child; D019140:Dental Care for Children; D003731:Dental Caries / Q000628:therapy; D003793:Dental Restoration, Permanent; D003796:Dental Service, Hospital; D003815:Dentists / Q000523:psychology*; D004739:England; D005792:General Practice, Dental; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D019239:Practice Patterns, Dentists'; D012017:Referral and Consultation; D013218:State Dentistry; D014081:Tooth Extraction; D014098:Toothache / Q000628:therapy
D000900:Anti-Bacterial Agents