Background: Multiple factors are involved in the assessment of children for dental treatment under general anaesthesia (GA). Guidelines published by the General Dental Council and the Royal College of Surgeons of England provide clinicians with a framework on which to base their assessment and contemporaneous record keeping.
Audit Methods: Standards of care for assessment of children undergoing dental treatment under GA were defined using the aforementioned guidelines. The target for compliance was 100% for the following six criteria: up-to-date medical history, alternatives to GA explored, justification for GA given, explanation of risk, information given to parent/ guardian about teeth involved, and obtaining written consent at the time of assessment. Current practice was compared to the standards by analysing 55 case notes retrospectively. Results and recommendations were disseminated to colleagues. The recommendations were piloted using a proforma in 14 patients to evaluate compliance with the standards.
Results: Initial results were as follows: medical history (100%), alternatives to GA explored (75%), justification for GA recorded (73%), explanation of risk recorded (67%), information given about teeth involved (17%) and obtaining written consent at the time of assessment (0%). Using the pilot proforma, written consent was obtained in 93% of cases and a considerable improvement was seen in the other categories.
Conclusion: The gold standard was achieved for providing information to parents/ guardians, however further improvement is required with respect to obtaining written consent and the remaining criteria. A proforma is useful to aid compliance with standards for paediatric dental GA assessment.