Abstract

BackgroundPatterns of service delivery and the organisation of Dental General Anaesthesia (DGA) have been found to differ across hospitals. This paper reports on qualitative research aimed to understand the impact of such variation by exploring views and experiences of families receiving care in different hospital sites, as well as dentists involved in referral and delivery of care.MethodQualitative semi-structured interviews were conducted with 26 people comprising parents (n = 15), dentists working in primary care (n = 6) and operating dentists (n = 5) in relation to DGA. Participants were recruited from areas across the North West of England to ensure a variety referral and treatment experiences were captured. Field notes were made during visits to all settings included in the study and explored alongside interview transcripts to elicit key themes.ResultsA variety of positive and negative impacts on children and parents throughout the referral process and operation day were apparent. Key themes established were clustered around three key topics:Organisational and professional concerns regarding referrals, delivery of treatment and prevention.The role of hospital environment and routine on the emotional experiences of children.The influence of the wider social context on dental health.ConclusionThese findings suggest the need and perceived value of: tailored services for children (such as play specialists) and improved information, such as clear guidance regarding wait times and what is to be expected on the day of the procedure. These features were viewed to be helpful in alleviating the stress and anxiety often associated with DGA. While some elements will always be restricted in part to the hospital setting in which they occur, there are several aspects where best practice could be shared amongst hospitals and, where issues such as wait times have been acknowledged, alternative pathways can be explored in order to address areas which can impact negatively on children.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0029-3) contains supplementary material, which is available to authorized users.

Highlights

  • Patterns of service delivery and the organisation of Dental General Anaesthesia (DGA) have been found to differ across hospitals

  • The influence of the wider social context on dental health. These findings suggest the need and perceived value of: tailored services for children and improved information, such as clear guidance regarding wait times and what is to be expected on the day of the procedure

  • These features were viewed to be helpful in alleviating the stress and anxiety often associated with DGA

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Summary

Introduction

Patterns of service delivery and the organisation of Dental General Anaesthesia (DGA) have been found to differ across hospitals. There are general guidelines as to the suitability of a child for DGA and clinical guidelines for the use of general anaesthetic in paediatric dentistry [4], these services have developed independently of such guidelines and present differing offers to patients. This could be for a variety of reasons; different workforce, for example, Consultants (in either paediatric, special care or oral surgery), Community Dental Service and General Dental Practitioners (GDPs) work within the service with different approaches and commissioners may have procured certain aspects of particular services. Previous research has indicated there is a variation in the organisation of DGA services, for example, some services have an “absence of agreed referral protocols and lack of, or unstructured approach to, pre-operative treatment planning consultation and assessment” [2]

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