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European Archives of Paediatric Dentistry

, Volume 1, Issue 2, pp 112–117 | Cite as

The use of general anaesthesia for the extraction of children’s teeth. Results from two UK Dental Hospitals

  • S. S. AlbadriEmail author
  • S. Lee
  • G. T. Lee
  • R. Llewelyn
  • A. S. Blinkhorn
  • I. C. Mackie
Article
  • 87 Downloads

Abstract

Aim: To study the reasons for giving children a general anaesthetic (GA), for the extraction of teeth, in two different paediatric dentistry centres and to compare them with the draft guidelines disseminated for discussion by the British Society of Paediatric Dentistry (BSPD). Study Design: Prospective study. Methods: Data were collected on children who required GA extractions over a two month period (1st May to 30th June 2004) at the Paediatric Dentistry Units of Liverpool University Dental Hospital (LUDH) and University Dental Hospital of Manchester (UDHM). The information collected included date of birth, gender, date of referral, date of assessment and date of GA. The reason for the GA was noted in terms of the proposed BSPD guidelines for a short dental GA. Results: A total of 264 and 268 children required extractions under GA at LUDH and UDHM respectively. At LUDH the main reason in 189 (72%) children was severe pulpitis requiring immediate relief of pain where the child does not have the intellectual maturity to cope with treatment under local analgesia (LA). This was followed by failed extractions under LA in 53 (20%) children. This reason is not listed under the proposed BSPD guidelines. At UDHM the main reason for GA for 114 (42%) children was symptomatic teeth causing pain in more than two quadrants (or in two quadrants necessitating the use of bilateral inferior dental blocks). Conclusions: There were differences in the clinical rational for GA between children attending the two centres. Further information is needed to refine the proposed guidelines on the use of GA for dental extractions in paediatric dentistry. The guidelines need to be flexible and updated to reflect changes in practice and service provision.

Key words

Teeth children General Anaesthesia 

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References

  1. Clayton M, Mackie IC. The development of referral guidelines for dentists referring children for extractions under general anaesthesia. Br Dent J 2003; 194:561–565.PubMedCrossRefGoogle Scholar
  2. General Dental Council: Maintaining Standard. November 1997. General Anaesthesia 4.17. (revised November 2001).Google Scholar
  3. Grant SM, Davidson LE, Livesey S. Trends in exodontia under general anaesthesia at a dental teaching hospital. Br Dent J 1998; 185:347–352.PubMedCrossRefGoogle Scholar
  4. Graves CE, Berkowitz RJ, Prokin HM, et al. Clinical outcomes for early childhood caries: influence of aggressive dental surgery. J Dent Child. 2004; 71: 114–7.Google Scholar
  5. Harrison M, Nutting L. Repeat general anaesthesia for paediatric dentistry. Br Dent J 2000; 189: 35–37.Google Scholar
  6. Holt RD, Al Lamki S, Bedi R, Dowey JA, Gilthrope M. Provision of dental general anaesthesia for extractions in child patients at two centres. Br Dent J 1999; 187: 498–501.PubMedGoogle Scholar
  7. Hunter ML, Hunter B, Dhir AP, Shah B. General anaesthesia for exodontia in children: experience of a dental teaching hospital in relation to changes in national guidelines. Int J Paed Dent 2002; 12: 260–264.CrossRefGoogle Scholar
  8. Landes DP, Bradnock G. Demand for dental extractions performed under general anaesthesia for children by Leicestershire community dental service. Comm Dent Health 1996;13:105–110.Google Scholar
  9. Low W, Tan S, Schwarts S. The effect of severe caries on the quality of life in young children. Pediatr Dent 1999; 21: 325–326.PubMedGoogle Scholar
  10. MacCormac C, Kinirons M. Reasons for referral of children to a general anaesthesia service in Northern Ireland. Int J Paed Dent 1998; 8: 191–196.CrossRefGoogle Scholar
  11. Mason C, Porter SR, Madland G, Parry J. Early management of dental pain in children and adolescents. J Dent 1997; 25:31–34.PubMedCrossRefGoogle Scholar
  12. Milsom KM, Tickle M, Blinkhorn AS. Dental pain and dental treatment of young children attending the general dental service. Br Dent J 2002; 192: 280–284.PubMedCrossRefGoogle Scholar
  13. Pitts NB. Inequalities in children’s caries experience: the nature and size of the UK problem. Comm Dent Health 1998; 15 Suppl 1:296–300.Google Scholar
  14. Podesta JR, Watt RG. A quality assurance review of the patient referral process and user satisfaction of outpatient general anaesthesia services for dental treatment. Comm Dent Health 1996;13: 228–231.Google Scholar
  15. Poswillo DE. General anaesthesia, sedation and resuscitation in dentistry: report of an expert working party. London: Department of Health, 1990.Google Scholar
  16. Shaw AJ, Meechan JG, Kilpatrick NM, Welbury RR. The use of inhalation sedation and local anaesthesia instead of General Anaesthesia for extractions and minor oral surgery in children: a prospective study. Int J Paed Dent 1996; 6: 7–11.CrossRefGoogle Scholar
  17. Sheller B, Williams BJ, Hays K, Mancl L. Reasons for repeat dental treatment under general anesthesia for the healthy child. Pediatr Dent 2003; 25: 546–552.PubMedGoogle Scholar
  18. Smallridge JA, Al Ghanim N, Holt RD. The use of general anaesthesia for tooth extraction for child out-patients at a London dental hospital. Br Dent J 1990; 168: 438–440.PubMedCrossRefGoogle Scholar
  19. Tochel C, Hosey M-T, Macpherson L, Pine C. Assessment of children prior to dental extractions under general anaesthesia in Scotland. Br Dent J 2004; 196: 629–633.PubMedCrossRefGoogle Scholar
  20. Tyrer G.L. Referals for dental general anaesthetics-how many really need GA?. Br Dent J 1999; 187: 440–444.PubMedGoogle Scholar
  21. Whittle JG, Jones CM, Hannon CP. Trend in the provision of primary care dental general anaesthesia in the north of England, 1991/1992 to 1994/1995. Br Dent J 1998; 184: 230–234.PubMedCrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2006

Authors and Affiliations

  • S. S. Albadri
    • 1
    Email author
  • S. Lee
    • 1
  • G. T. Lee
    • 2
  • R. Llewelyn
    • 2
  • A. S. Blinkhorn
    • 1
  • I. C. Mackie
    • 1
  1. 1.Paediatric Dentistry, School of DentistryUniversity of ManchesterManchesterUK
  2. 2.Department of Clinical Dental ScienceUniversity of LiverpoolLiverpoolEngland

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