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The role of pre-general anaesthetic assessment for patients referred by general dental practitioners to the Community Dental Service.

The first aim of this study was first to investigate the effectiveness of seeing patients at a separate appointment prior to any subsequent appointment for the administration of an anaesthetic, for patients referred from general dental practitioners to the Community Dental Service for dental extractions under general anaesthesia. The second aim was to assess the technical adequacy of the information contained in the referrals from general practitioners for the safe provision of extractions under general anaesthesia. The purposes of the assessments were to reduce the number of patients receiving a general anaesthetic, to ensure that the anaesthetist had a satisfactory medical history for the safe administration of an anaesthetic and that the dental officer undertaking the extractions had satisfactory clinical information to undertake the proposed dental care. A sample of records of patients seen at assessment appointments was drawn from a twelve month period. Five hundred and ninety-three patients records were used. One hundred and five cases required further investigations before an anaesthetic could be given. In 264 cases extractions were undertaken as requested by their own dentist, 208 patients had their treatment plans altered, 49 cases had extractions performed with local anaesthesia and 41 cases were discharged without any treatment. The pre-general anaesthetic assessment appointments prevented the need for a general anaesthetic for 15 per cent of referrals from general dental practitioners.