Dental council aims to cut anaesthetic rate

BMJ 1998; 317 doi: (Published 21 November 1998) Cite this as: BMJ 1998;317:1407
  1. Richard Woodman
  1. London

    A sharp reduction in dental general anaesthesia is expected in Britain after last week's action by the General Dental Council to stop patients being anaesthetised by inadequately trained practitioners or when proper procedures for resuscitation are not in place.

    Whether for cultural reasons or because of the “fee for service” incentive, 350000 dental general anaesthetics are administered each year–one of the highest rates in the world. On average two or three people still die each year despite higher standards introduced by the 1991 Poswillo report.

    The council's revised guidance comes into effect immediately, together with a warning that practitioners who disregard it may face a charge of serious professional misconduct.

    Under the new rules, before any procedure is carried out under general anaesthetic, patients must be given a thorough and clear explanation of the risks and the alternative methods of pain control. Only anaesthetists on the General Medical Council's specialist register, trainee anaesthetists in approved training programmes, or non-consultant career grade anaesthetists working under the supervision of a named consultant in the same NHS anaesthetic department are allowed to administer general anaesthetic.

    In addition, the correct procedures must be in place for monitoring and resuscitating patients, including arrangements for the immediate transfer of a patient to a critical care facility if necessary.

    The council expects that the availability of dental treatment under general anaesthesia will be greatly reduced, particularly in general dental practice.

    Leo Strunin, president of the Royal College of Anaesthetists, which strongly supports the council's action, said: “This year we have had five deaths and a very large number of clinical incidents.”

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