title: A study of the provision of hospital based dental General Anaesthetic services for children in the North West of England: Part 2--the views and experience of families and dentists regarding service needs, treatment and prevention.
abstract: BACKGROUND
  Patterns of service delivery and the organisation of Dental General Anaesthesia (DGA) have been found to differ across hospitals. This paper reports on qualitative research aimed to understand the impact of such variation by exploring views and experiences of families receiving care in different hospital sites, as well as dentists involved in referral and delivery of care.
  
  
  METHODS
  Qualitative semi-structured interviews were conducted with 26 people comprising parents (n = 15), dentists working in primary care (n = 6) and operating dentists (n = 5) in relation to DGA. Participants were recruited from areas across the North West of England to ensure a variety referral and treatment experiences were captured. Field notes were made during visits to all settings included in the study and explored alongside interview transcripts to elicit key themes.
  
  
  RESULTS
  A variety of positive and negative impacts on children and parents throughout the referral process and operation day were apparent. Key themes established were clustered around three key topics: 1. Organisational and professional concerns regarding referrals, delivery of treatment and prevention. 2. The role of hospital environment and routine on the emotional experiences of children. 3. The influence of the wider social context on dental health.
  
  
  CONCLUSIONS
  These findings suggest the need and perceived value of: tailored services for children (such as play specialists) and improved information, such as clear guidance regarding wait times and what is to be expected on the day of the procedure. These features were viewed to be helpful in alleviating the stress and anxiety often associated with DGA. While some elements will always be restricted in part to the hospital setting in which they occur, there are several aspects where best practice could be shared amongst hospitals and, where issues such as wait times have been acknowledged, alternative pathways can be explored in order to address areas which can impact negatively on children.
authors.affiliation: The Dental Health Unit School of Dentistry, The University of Manchester, Williams House, Manchester Science Park, Manchester, M15 6SE, UK. michaela.goodwin@manchester.ac.uk.
authors.forename: Michaela
authors.initials: M
authors.lastname: Goodwin
authors.affiliation: The Dental Health Unit School of Dentistry, The University of Manchester, Williams House, Manchester Science Park, Manchester, M15 6SE, UK. Iain.A.Pretty@manchester.ac.uk.
authors.forename: Iain A
authors.initials: IA
authors.lastname: Pretty
authors.affiliation: Centre for Primary Care, The University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK. Caroline.Sanders@manchester.ac.uk.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sanders
mesh_terms: D000293:Adolescent; D000766:Anesthesia, Dental / Q000523:psychology; D000768:Anesthesia, General / Q000523:psychology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016854:Dental Anxiety / Q000523:psychology; D019140:Dental Care for Children / Q000458:organization & administration*; D003731:Dental Caries / Q000517:prevention & control; D003796:Dental Service, Hospital / Q000458:organization & administration*; D003815:Dentists / Q000523:psychology*; D004644:Emotions; D004739:England; D006272:Health Facility Environment; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020380:Needs Assessment; D010290:Parents / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D012017:Referral and Consultation; D013315:Stress, Psychological / Q000523:psychology; D014850:Waiting Lists