Prevention in the context of caries-related extractions under general anaesthesia: an evaluation of the use of sealants and other preventive care by referring dentists.

Introduction Children requiring a general anaesthetic (GA) for caries-related dental extractions are at high risk of developing new dental caries. It is therefore important to maximise opportunities for prevention.Aim To explore the use and scope for fissure sealants among children requiring caries-related dental extractions under GA and investigate ongoing oral health support following treatment under GA.Methods Service evaluation (baseline at GA and two years later) including dental examination and structured interview questionnaires, involving children (aged five to 15 years) attending Birmingham Dental Hospital for caries-related dental extractions under GA.Results Of 352 children, 62.5% had at least one sound and sealable first permanent molar at the time of the GA (77% of 6-8-year-olds). Of those that could be followed up two years later (39), 5% had clinical evidence of sealants in first permanent molars. Two thirds saw a dentist after the GA and, of these, 85% had received oral hygiene instruction, 77% dietary advice and 15% application of fluoride varnish. One third presented with untreated dentine caries in at least one first permanent molar recorded as sound at baseline.Conclusion There is an unmet need for preventive treatments, particularly sealants, in this high-risk group. The two-year incidence of caries in first permanent molars that are sound at the time of the GA is high. There may be scope for the provision of fissure sealants as part of the GA encounter.