A rapid review of variation in the use of dental general anaesthetics in children

Broomhead, Tom; Rodd, Helen; Baker, Sarah R.; Jones, K.W.; Davies, Gill; White, Sandra; Marshman, Zoe

doi:10.1038/s41415-020-1846-6

Cited by 13 publications

(30 citation statements)

References 122 publications

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“…This study also indicated that the majority of patients referred for treatment under GA/sedation had a mean age of 5.9 years. These findings were consistent with other reports examining the treatment and outcomes of children receiving GA [3,5,7,[12][13][14].…”

Section: Discussionsupporting

confidence: 92%

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A Preliminary Study of the Treatment Outcomes of Paediatric Dental Patients Referred for General Anaesthesia or Sedation at a Regional Hospital in Trinidad

Percival

Bhagoutie

2021

Children

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General anaesthesia and sedation are known to be useful adjuncts in the care of paediatric dental patients. There are several challenges that prevent patients from receiving care. Aim: To assess the treatment outcomes of paediatric dental patients seen at an emergency facility who were referred for treatment under sedation or general anaesthesia at a regional hospital in Trinidad. Methods: Records of patients seen at the Child Dental Health Unit Emergency clinic at the University of The West Indies Dental School from 2012 to 2017 were assessed. The parents of children referred for general anaesthesia or sedation at the regional hospital were then interviewed via telephone. Results: Most children (53.4%) were younger than 6 years old and the most common reasons for referral were the treatment of multiple carious teeth and behaviour management. Furthermore, 66.1% of cases did not receive treatment and had a mean waiting time of 4.7 years, and 61.7% of referred cases needed emergency care while awaiting general anaesthesia or sedation. Limited access to these services and the high cost of treatment were the main reasons for non-treatment. Conclusion: There is significant need for the timely treatment of paediatric dental patients referred for general anaesthesia or sedation. Improved availability and accessibility of these services could improve patients’ quality of life.

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Section: Discussionsupporting

confidence: 92%

“…The significant delay in receiving treatment can be due to a variety of patient-related and institution-related factors [14,22,23]. Limited access to affordable GA/sedation services for children was reported to be the main barrier for many parents.…”

Section: Discussionmentioning

confidence: 99%

A Preliminary Study of the Treatment Outcomes of Paediatric Dental Patients Referred for General Anaesthesia or Sedation at a Regional Hospital in Trinidad

Percival

Bhagoutie

2021

Children

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“…37 Along with the cessation of routine dental services in March 2020, many hospitals throughout England also cancelled elective tooth extraction lists and comprehensive care lists in order to accommodate the anticipated increased capacity needed to treat COVID-19 patients. 38,39 The lower provision of these services also impacts people from vulnerable groups (for example, those with learning disabilities) who may require hospital services, often with general anaesthesia, for the provision of dental care.…”

Section: Access To Secondary Dental Carementioning

confidence: 99%

“…37 admissions for tooth extractions are strongly socially patterned with children living in more deprived areas being more likely to receive this care and have more teeth removed during an episode. 37,38 The reduction in hospital tooth extractions impacted, in terms of absolute numbers, more upon the deprived children, even though it was proportionately similar across socio-economic groups. For example, the rate of hospital tooth extraction episodes per 100,000 population dropped from 122 between March to May 2019 to 30 between March to May 2020 among the most deprived children (a difference of 92 per 100,000), while the respective figures among the least deprived were 31 and 7, a difference of 24 per 100,000 (Fig.…”

Section: Access To Secondary Dental Carementioning

confidence: 99%

The impact of the COVID-19 pandemic on oral health inequalities and access to oral healthcare in England

Stennett

Tsakos

2022

Br Dent J

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While the impact of the coronavirus disease (COVID-19) pandemic on health inequalities is documented, oral health has been absent from this discussion. This commentary highlights the potential impacts of the COVID-19 pandemic on oral health inequalities in England in February 2021. It includes a literature review, Public Health England and Kantar Worldpanel sales data on health behaviours and analysis of NHS dental services data. Purchasing data indicate, except for smoking, increases in health-compromising behaviours. Since the resumption of dental services, NHS general dental service use modestly recovered among adults but not children by October 2020. There are clear inequalities among children and older adults, with more deprived groups having lower uptake of dental service use than more affluent groups. Oral cancer referrals and hospital admissions for tooth extractions in children dramatically declined, with the latter primarily affecting children in more deprived areas. Many oral health programmes in schools and care homes were disrupted or suspended throughout this period. All these indicate that oral health inequalities have widened due to the COVID-19 pandemic. An oral health plan of action requires prioritising long-term investment in public health programmes and transforming commissioning pathways to support those with the greatest needs to access oral healthcare services.

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“…34 Further evidence is provided by an extensive review of variations in the use of general dental anaesthesia for children. 35 A survey of 1,783 children compared artificially fluoridated water in Newcastle to Manchester. While the level of deprivation for both cities was comparable, there was significantly less caries experience in Newcastle.…”

Section: Fces As % Of 0-5-year-oldsmentioning

confidence: 99%

Childhood caries and hospital admissions in England: a reflection on preventive strategies

Levine

2021

Br Dent J

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Dental caries is a largely preventable disease, yet the extraction of carious teeth is the most common reason for the hospital admission of children in England. This raises concern over the perceived failure of current preventive strategies. Despite a number of national and local preventive strategies, childhood caries remains most prevalent among the lower socioeconomic groups and ethnic minorities, especially in northern England. Often overlooked is the social and emotional impact of caries and dental treatment on the children and their families. More long-lasting can be the emotional, psychological and developmental impact on children of dental treatment and extractions under general anaesthesia, especially in unfamiliar hospital settings. Yet, the number of hospital admissions for the 5-9-yearold age group continues to rise and was 26,000 in England in 2018. The aim of this paper is to review the demographic and socioeconomic factors related to hospital admission of children for dental extractions, focusing on the localities with the highest proportions of hospital admissions. It is suggested that a reappraisal of the caries-preventive strategy in those areas of England with the highest proportion of hospital admissions is now urgently needed and the case is forcefully made for targeted water fluoridation.

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A rapid review of variation in the use of dental general anaesthetics in children

Cited by 13 publications

References 122 publications

A Preliminary Study of the Treatment Outcomes of Paediatric Dental Patients Referred for General Anaesthesia or Sedation at a Regional Hospital in Trinidad

A Preliminary Study of the Treatment Outcomes of Paediatric Dental Patients Referred for General Anaesthesia or Sedation at a Regional Hospital in Trinidad

The impact of the COVID-19 pandemic on oral health inequalities and access to oral healthcare in England

Childhood caries and hospital admissions in England: a reflection on preventive strategies

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