Research abstract
British Dental Journal 196, 629 - 633 (2004)
Published online: 22 May 2004 | doi:10.1038/sj.bdj.4811281
Assessment of children prior to dental extractions under general anaesthesia in Scotland
C Tochel1, M -T Hosey2, L Macpherson3 & C Pine4
- This paper will facilitate future definition of what is involved in assessment prior to chair dental general anaesthesia (CDGA).
- It will prompt some debate about the location of assessment services in relation to the CDGA service and to conscious sedation alternatives.
- It will prompt discussion about the level of training and experience required by the dental 'assessors', should they be specialist paediatric dentists?
- This paper might also prompt further guideline development in relation to the CGDA pathway of care.
Abstract
Objective To determine the type of dental assessment service offered to children prior to exodontia under chair dental general anaesthesia (CDGA) in the community and hospital dental services (CDS, HDS) in Scotland.
Design and setting Telephone interviews were conducted with CDS and HDS clinical directors in Scotland using a semi-structured questionnaire, with written follow-up confirmation. Copies of CDGA referral forms were also requested.
Results All clinical directors, or their nominated deputies, participated (n = 21). Almost half of interviewees indicated that their area offered a 'dedicated' pre-CDGA assessment service (n = 10). A range of grades was identified amongst assessors; a minority were described as 'specialist paediatric staff'. The availability of CDGA alternatives, including local analgesia and conscious sedation varied. Changes to the referral treatment plan were reported to occur 'sometimes' or 'often' by 11 interviewees regarding the anaesthetic used, and by 16 respondents regarding the number of teeth extracted. The content of CDGA referral forms was diverse.
Conclusions The method of referral and assessment of children for CDGA in Scotland is diverse, partly reflecting geographic limitations and local need. Guidance on pre-GA assessment, including use of standardised referral forms, may reduce variation and improve the quality of the pathway of care.
- Research Assistant, University of Glasgow Dental School, 78 Sauchiehall Street, Glasgow, G2 3JZ
- Senior Lecturer/Honorary Consultant in Paediatric Dentistry, University of Glasgow Dental School, 78 Sauchiehall Street, Glasgow, G2 3JZ
- Senior Lecturer/Honorary Consultant in Dental Public Health, University of Glasgow Dental School, 78 Sauchiehall Street, Glasgow, G2 3JZ
- Professor of Dental Public Health and Primary Dental Care, Department of Clinical Dental Sciences, Liverpool University Dental Hospital and School of Dentistry, Pembroke Place, Liverpool L3 5PS
Correspondence to: M -T Hosey2 e-mail: m.t.hosey@dental.gla.ac.uk