Trends in exodontia under general anaesthesia at a dental teaching hospital

Aims To survey the use of simple exodontia for children under general anaesthesia on an out-patient basis at a Northern Dental Hospital. To monitor any effects resulting from the introduction of the Poswillo guidelines on the referral for and treatment of patients under general anaesthesia. Design A retrospective longitudinal analysis. Setting A Northern Dental Hospital in England. Materials Information was recorded from original case records of children undergoing exodontia under general anaesthesia on an out-patient basis during October between 1989 and 1997. Results The mean and modal age of the children decreased from 7.7 years to 6.0 years respectively in 1989 to 5.7 years and 4.0 years in 1997. The proportion receiving a general anaesthetic for orthodontic extractions substantially decreased from 18.0% in 1989 to 0.7% in 1997 and the need for repeat dental general anaesthetics within 18 months was eliminated with the introduction of a pre-general anaesthetic screening service. Conclusion Dental treatment under general anaesthesia should continue to be available where it is justified. A separate assessment appointment reduces the prescription of general anaesthesia and minimises its usage for orthodontic extractions and the necessity for repeat general anaesthesia.