Do referrals from primary dental care for treatment using general anaesthesia comply with General Dental Council guidelines?

OBJECTIVES

To investigate the quality of information in referrals for patients aged under 16 years referred for dental extraction under general anaesthesia (GA), to ascertain the knowledge and expectations of the parents of these patients, and to determine whether the number of teeth extracted in secondary care coincides with that of the referring dentist.

DESIGN

Retrospective study of referrals of all patients aged under 16 years referred to community dental clinics in Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire over a 26-day period.

RESULTS

The majority (62.2%) of the 251 referrals examined were for extractions under GA. Of these, 125 were by letter and 117 using a pro forma. Significantly more pro formas (33) than letters (8) contained a full medical history (P < 0.001). A treatment plan was included in significantly more pro formas (76) than letters (49) (P < 0.01). Few referrals contained a note about the discussion of alternatives to a GA procedure and only 37% (58/156) of parents reported that the referring general dental practitioner had discussed alternative treatments with them. A total of 551 primary teeth were indicated for removal but 846 teeth were eventually removed.

CONCLUSIONS

Our findings indicate a need for parents of patients referred for GA procedures to be better informed about alternatives. Improvement in the quality of referrals, perhaps with the aid of standard pro formas, would also facilitate more effective management of referred patients.