Impact of Long Waits on Treatment Plan Validity among Paediatric Patients Listed For Dental Extraction under General Anaesthesia

Abstract

Introduction: Dental caries has a significant impact on the oral, general and psychological health of children. In the latest oral health survey of 5 year old children, almost one-quarter of 5 year old children in the UK had experienced dental caries. General anaesthesia (GA) may be necessary to provide dental treatment for children, but waiting times in the UK are a substantial challenge and may lead to children developing symptoms of dental pain and infection and possible requiring additional extractions on the day of operation. Aim: To determine the impact of long waits on treatment plan validity amongst paediatric patients listed for dental extraction under general anaesthesia in the Manchester University Foundation Trust. Method: This was a retrospective, electronic case-note analysis service evaluation. All paediatric dental patients who attended for dental extractions under GA between December 2019 and February 2020 were included which gave a convenience sample of 103 patient records. Data regarding patient waiting time for GA, any symptoms experienced while waiting and validity of each treatment plan was collected. Results: Out of 103 case records, 54 cases were female and 49 were male. Median age at the time of GA was 7 years [IQR 5 -9]. Significantly more teeth were extracted then planned with a median of 7 [4-10] teeth per child planned to be extracted and 8 [5-12] eventually extracted (Wilcoxon Signed Rank, p=0.006). In 41 (40%) subjects, the planned number of teeth extracted was identical to what was planned. With a median of waiting time of 341 days [322-344], the amount of time on the waiting list was not correlated with the numbers of lost teeth or the difference between planned and extracted teeth Conclusion: This service evaluation has highlighted the possible detrimental effects of long waiting times for children who need dental extractions under GA.