GGC - Oral Health
- Urgent extraction of carious teeth under General Anaesthesia - multiple episodes pain/infection and multiple courses of antibiotics or where pain cannot be controlled with analgesia
PDS Paediatric Referral Criteria
Warning
Pain and sepsis are not automatic triggers for referral. Both can be resolved and controlled by local means in Primary Care GDS. Temporary measures can defer permanent treatment until the child is older and more cooperative.
Referral for extraction(s) should be seen as part of an overall management plan.
The referring dentist retains responsibility for patient continuing care. Prior to extraction, much can be done in the way of expectations, acclimatisation and home care.
If a child is accepted for GA extractions a radical approach will be taken and all teeth with established caries will be extracted. This is to minimise the risk of a repeat GA episode.
- Dental treatment under inhalation sedation due to anxiety.
- Behavioural issues - where the management is beyond the scope of the GDP - patient acclimatisation should have been attempted by the referring GDP
- Intellectual Disabilities - where the management is beyond the scope of the GDP and the level of care required requires referral
- Dental anxiety - where the management is beyond the scope of the GDP - acclimatisation must have been attempted by GDP in first instance
- Routine extraction of carious teeth under General anaesthesia - A child in pain/recurrent episodes of pain and/or sepsis and all treatment options have been considered and attempted and where pain can be controlled with analgesia
- Specialist opinions or specialist treatment planning
- Complex medical conditions including haematological conditions eg haemophilia, von Willibrands
- Restorative treatment under general anaesthetic
- Requests for treatment under intravenous sedation
- Age 15+ and inhalation sedation required – refer to alternative primary care sedation practice due to PDS current waiting times for assessment and treatment with inhalation sedation.
- Requests for surgical extractions – refer to Oral Surgery or Paediatric Dentistry
- Routine primary care (e.g. caries in cooperative children, endodontic treatment in permanent teeth with closed apices, aesthetic treatments).
- Endodontic treatment in permanent molars unless there is good clinical indication for retention of the compromised tooth i.e. severe hypodontia
- Acclimatisation of paediatric patients
- Orthodontic opinions
- Extraction of asymptomatic carious deciduous teeth under General Anaesthesia
- Orthodontic extractions with or without sedation
- Preformed metal crowns due to none available in practice
- Dental treatment for ASA3 children under inhalation sedation or general anaesthetic