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Biomedical subjects

R D Holt

Publications and source records attributed to R D Holt.

74 records · Page 5Linked to original sources

The use of general anaesthesia for tooth extraction in children in London: a multi-centre study.

Following publication of the Poswillo report, the continued use of general anaesthesia in dentistry became the subject of a major debate. In particular, the provision of general anaesthetic services by general dental practitioners in order to carry out simple extractions for child patients has been called into question. Other authors have strongly supported the continued need for general anaesthesia and insist that for some patients it remains the technique of choice. There is, however, little evidence of current patterns of attendance from which argument may be advanced to support or refute the differing views. In this study data was drawn from three London dental teaching hospitals providing out-patient general anaesthesia for extractions. During the 12-month period investigated 7852 general anaesthetics had been administered for child patients. There was evidence of an increase in numbers at one centre when results were compared to those of a previous study and some evidence of a change in pattern of referral with time at the same centre, with an increase in the numbers of patients referred by general dental practitioners. Eighty-three per cent of the anaesthetics had been given for the extraction of carious primary teeth, with an average of 3.3 being extracted per child. Nearly one-third of the anaesthetics were for children under the age of 5 years.

Analysis of Variance↗

Caries in pre-school children in Camden 1993/94.

Previous surveys carried out in the inner city area of Camden between 1966 and 1986 gave indication of a deterioration in dental health in pre-school children during the 1980s. Four hundred and six children were included in the current survey, which used the same sampling and methodology as previously. The aims of the present survey were to determine the current prevalence of caries and of rampant caries and to relate prevalence to social factors, to infant feeding habits and to the use of sweetened comforters, and to determine the extent of dental care received. Caries affected 11% of 2-year-old children and 29% of 3-year-olds, rampant caries affected 6% and 14% respectively. A higher likelihood of caries occurred in children of Asian origin and those given a sweetened comforter. For rampant caries, likelihood was greater amongst those of Asian origin and those given a sweet drink in a bottle for 2 years or longer. Comparison with results of the last study provides little evidence of improvement in dental health in young children in this low fluoride area, with a small proportion suffering relatively severely from caries.

Bottle Feeding↗