title: Prospective study on dental extractions carried out for paediatric patients under general anaesthetic in a district general hospital.
abstract: BACKGROUND
  The first line approach to managing healthy anxious children requiring dental extractions should include behavioural management and treatment under local anaesthetic. This can be coupled with conscious sedation.
  
  
  OBJECTIVE
  To evaluate alternative methods attempted prior to treatment under general anaesthesia (GA), to establish the incidence of repeat GA procedures.
  
  
  METHODS
  Paediatric cases requiring dental extractions under GA were audited from October 2014 - December 2014 in the Oral and Maxillofacial Department, Great Western Hospital, Swindon.
  
  
  RESULTS
  78 paediatric cases requiring dental extractions were carried out during the study period. 91% of referrals came from local general dental practitioners (GDPs). The indication for the GA was included in 59% of the referral letters. The number of teeth extracted per case ranged from 1 - 14. In 18% of cases treatment under local anaesthetic had been attempted previously. Conscious sedation had not been attempted in any of the cases. There were 5 cases (6.4%) of repeat general anaesthetic procedures.
  
  
  CONCLUSIONS
  Local guidance regarding appropriate paediatric referrals should be distributed to primary care referrers. Treatment under conscious sedation should be considered for paediatric cases and an improved referral pathway to the community dental service should be developed. Preventative advice should be reinforced to the referrer and to the patient.
authors.forename: Tom
authors.initials: T
authors.lastname: Friend
authors.forename: Paul
authors.initials: P
authors.lastname: Allen
mesh_terms: D000293:Adolescent; D000766:Anesthesia, Dental / Q000706:statistics & numerical data*; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000706:statistics & numerical data; D019230:Dental Audit; D019140:Dental Care for Children / Q000706:statistics & numerical data; D004739:England; D005260:Female; D005792:General Practice, Dental / Q000706:statistics & numerical data; D006767:Hospitals, District / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014081:Tooth Extraction / Q000706:statistics & numerical data*