"The long term implicationsfor thefuture ofDental Anaesthetic Practice in
Lincolnshirefollowing the General Dental Council's Guidelines ofNovember
The subject of this thesis is based on the continuing requirements of patients for
dental anaesthesia following the revised General Dental Council (GDC) Guidelines of
The factors to be considered in particular are issues which directly apply to referred
patients for a dental general anaesthetic (DGA) namely - social class, gender,
ethnicity, occupation, background education, attitude towards dental treatment and
pre-operative medical history. In addition to considering the issues involved in
assessing the suitability of patients for a general anaesthetic (GA) attention will be
paid to the General Dental Practitioners (GDP) rationale for referring a patient for GA
and whether the choice of such treatment was in any way influenced by the mindset of
the patient. Issues relating to case selection will be taken into account along with the
steps taken to avoid a repeat anaesthetic. The factors which motivate a GDP to offer
GA, sedation or LA will be examined along with the possible reasons which guided
the patient to make that decision. A look to the future will be undertaken with regard
to GA and sedation services in the UK subsequent to the November 1998 guidelines
with some emphasis placed on the adult use of such services.
In order to assess the implications and effects of the GDC guidelines on GA services,
a study of the attitudes and opinions of both referring and treating dentists was
undertaken. This study also took into account the views and attitudes of patients both
pre- and post-assessment.
The methodology used was both qualitative and quantitative in nature involving the
use of questionnaires; two questionnaires were sent to the referring and clinical
dentist. The purpose of the questionnaire to the clinical dentists was to determine
referral patterns post-guidelines and to monitor compliance with these, whilst the
questionnaire to the treating dentists was designed to monitor attitudes regarding
referrals for treatment. Likewise patients were given two questionnaires to determine
whether patients referred for GA, sedation or LA were satisfied with the treatment
plan and subsequent outcome.
Since the Poswillo Report of 1990 there have been general recommendations to move
from the position of GA towards sedation. Correspondingly part of the referring
dentists questionnaire contained a section on this aspect of patient care.
The results of the study are considered in detail and inferences drawn relating to the
present and future provision of both GA and sedation in the UK.