Experience of Paediatric Patients on the General Anaesthesia Dental Extraction Waiting List at Manchester University Foundation Trust – A Service Evaluation

Abstract

Background: Early childhood caries (ECC) is one of the most common diseases in childhood, despite being a largely preventable condition. A high percentage of children suffering from ECC are placed on the waiting list for dental treatment under general anaesthesia (GA). The high demand on dental GA services result in a prolonged waiting time, often resulting in deterioration of children’s oral and general health and negatively affecting their growth and quality of life. Aim: To investigate the experience of children on the waiting list for dental extractions under general anaesthesia, including preventive and restorative care provided prior to GA and the utilisation of play therapy services available at the Royal Manchester Children’s Hospital. Methods: This was a retrospective, electronic case note service evaluation. Data was collected from the clinical records of paediatric patients who underwent dental extractions under GA at the Royal Manchester Children’s Hospital from December 2019 to January 2020. Results: 100 patient records were included, of these 56% were male and 46% female with an average age of 6.3 years. The most common presenting complaint was pain (58%) followed by dental caries (32%). On average, children waited for 3.28 months for their initial assessment and spent 7.87 months on the GA waiting list. Lack of cooperative ability was the most common justification for listing for GA (63%). Twenty-four percent of children had no experience of preventive care and 63% of them had no experience of restorative treatment prior to GA. Conclusion: These findings show that preventive and restorative care provided to high caries risk children is suboptimal. Public education regarding the importance of regular dental visits, emphasis on preventive advice and utilizing SDF and other fluoride treatments can reduce the morbidity of dental caries and minimise the need for specialist care under GA for uncooperative children.