739 A Service Evaluation of Post-Operative Risks for Surgical Dental Procedures Following Paediatric Out-Patient General Anaesthetic

Aim

To evaluate post-operative outcomes for paediatric patients who have undergone surgical procedures under general anaesthetic in the out-patient day surgery unit.

Method

A retrospective evaluation of all children under 16 years old who attended for Day Surgery procedures between 1/10/22 and 31/12/22 at Guy’s Hospital, London was completed.

Patient notes were assessed to identify surgical procedures, the risks the patient had been consented for pre-operatively and the incidence of post-operative risks.

Results

In the 2-month period, 303 patients were seen in Day Surgery. 209 completed a course of comprehensive dental care, 94 required exodontias only and 21 had a surgical extraction included in their treatment under general anaesthetic.

1 patient experienced a risk that had been planned for: an oro-antral communication following removal of an infra-occluded maxillary molar.

1 patient required an apically repositioned flap after unfavourable positioning of the orthodontic bracket during exposure and bonding of an unerupted tooth.

2 patients were offered a telephone review post-operatively and no patients required a face-to-face review.

Conclusions

All patients requiring dental surgical procedures should be consented for appropriate risks including damage to adjacent structures and possible altered sensation if nerve tissue is close to the expected surgical site. The possibility of oro-antral communication should also be addressed pre-operatively. Where exposure and bonding of orthodontic brackets are planned, the risk of a change in the gingival contour and health should be outlined. By comprehensively discussing possible post-operative complications, patient expectations and care can be optimised, and consent can be fully informed.