General anaesthetic service for adult dental extractions: an 'À La Carte Menu'? Survey results

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The case selection for adult dental extraction under general anaesthesia (GA) is inevitably subjective. A culture of overprescription has implications for patient safety as well as for the limited resources of the National Health Service. We explored the current perceptions and opinions of clinicians in oral and maxillofacial surgery (OMFS) units throughout the UK on various aspects of adult dental extraction under general anaesthesia (DGA) service. An email with an electronic survey link was sent to members of the British Association of Oral and Maxillofacial Surgeons and postgraduate dental deaneries. An institutional response rate of 67.3% was reached (241 clinicians of varying grades from 107 out of 159 oral and maxillofacial surgery units in the UK). There was a general consensus that the culture of demand-driven adult DGA exists and needs to be addressed. However, opinions were divided and varied on how this could be achieved. A small majority (58.1%) were in favour of adult DGA guidelines and this group provided suggestions for selection criteria. Those that did not feel such guidelines would improve the situation were pessimistic of the potential for change in patients' attitude towards DGA. This group cited the poor adherence to other existing guidelines, or suggested alternative ideas to guidelines.

Key Points

  • Encourages professional debate about the provision of adult GA dental extraction service amongst dental professionals.

  • Many clinicians in oral and maxillofacial units currently perceive a strong culture of demand-driven adult GA dental extraction, and there is a need to address this issue.

  • Highlights the need to review the current provision of sedation in oral and maxillofacial units in the UK

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We are grateful to BAOMS and postgraduate dental deaneries for helping in the circulation of this survey.

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Correspondence to B. Hong.

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