The use of general anaesthesia for the extraction of children's teeth. Results from two UK dental hospitals.

AIM

To study the reasons forgiving children a general anaesthetic (GA) for the extraction of teeth, in two different paediatric dentistry centres and to compare them with draft guidelines disseminated for discussion by the British Society of Paediatric Dentistry (BSPD).

METHODS

Data were collected on children who required GA extractions over a two month period (1st may to 30th June 2004) at the Paediatric Dental Units of Liverpool University Dental Hospital (LUDH) and the 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 short 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 a 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 in 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 rationale 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.