title: Issues arising following a referral and subsequent wait for extraction under general anaesthetic: impact on children.
abstract: BACKGROUND
  Untreated caries in young children can result in a referral for extraction in hospital under general anaesthetic (GA). This study aims to explore the impact of caries during the ensuing wait for GA on children resident in the North West of England.
  
  
  METHODS
  The study involved 456 respondents referred to six hospitals in the Northwest of England. Over a two-month period each of these children/ families completed a questionnaire and gave permission to access their referral and consultation notes.
  
  
  RESULTS
  Children (6.78 years old: 1.50 to 16.42) had on average five teeth extracted (ranging from one to a full clearance, with all teeth removed). Sixty seven per cent of parents reported their child had been in pain, 26% reported schools days being missed and 38% having sleepless nights. The average time from referral to operation was 137 days. Results indicated that children could be in discomfort during their wait, as pain was experienced, on average, 14 days before the operation. Wait time significantly predicated the number of sleepless nights b = .004, t(340) = 2.276, p = .023.
  
  
  CONCLUSIONS
  It is clear that pain, sleepless nights and missed school are a feature during a wait for dental GA and can be exacerbated by an extended wait. These data support the need for not only effective prevention of caries within primary care to reduce wait times and experience of GA but also effective management of pain and infection during a prolonged wait for treatment.
authors.affiliation: The Dental Health Unit, School of Dentistry, The University of Manchester, Williams House, Manchester Science Park, M15 6SE Manchester, England. michaela.goodwin@manchester.ac.uk.
authors.forename: Michaela
authors.initials: M
authors.lastname: Goodwin
authors.forename: Caroline
authors.initials: C
authors.lastname: Sanders
authors.forename: Gill
authors.initials: G
authors.lastname: Davies
authors.forename: Tanya
authors.initials: T
authors.lastname: Walsh
authors.forename: Iain A
authors.initials: IA
authors.lastname: Pretty
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000766:Anesthesia, Dental / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D001007:Anxiety / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000150:complications / Q000628:therapy; D003796:Dental Service, Hospital; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011788:Quality of Life; D012017:Referral and Consultation; D012893:Sleep Wake Disorders / Q000209:etiology; D014081:Tooth Extraction / Q000379:methods*; D014098:Toothache / Q000209:etiology; D014850:Waiting Lists