Referring a patient for sedation or general anaesthetic

General anaesthetia

Treatment will only be offered following an assessment initiated by the receipt of a completed referral form. Referrals are normally only accepted from the community dental services. If you are considering referring a patient from general practice, then please initially refer to the local CDS.

Adults accepted for consultation will be assessed and should their treatment needs be deemed manageable within the community dental services, they will be returned with appropriate advice.

Patients will be accepted for general anaesthesia if the patient:

  • has moderate to severe learning disabilities
  • has a congenital/ genetic condition that reduces the patient’s cooperation with routine behaviour management techniques
  • has severe airway problems that are best managed under GA, and where IV sedation is contraindicated

is ASA I, II and III (ASA IV patients will still be assessed but may not be offered a GA following an anaesthetic assessment)

Referred patients who will not receive a consultation appointment for general anaesthesia

Referrals may not be accepted:

  • if incomplete or insufficient information is provided i.e. “see and treat”
  • if sent for financial / economic reasons
  • if the patient has no special care needs other than dental anxiety
  • if a GA is requested for social reasons e.g. if the patient cannot provide an escort for intravenous sedation
  • if the patient has been directly referred by a GDP/GMP
  • for common medical history problems that are manageable within CDS/GDS e.g. warfarinised patients

Sedation

Intravenous sedation will only be offered to patients over 16 years of age (or competent adolescents aged 14 years and over) and who are deemed to be appropriate for this treatment modality after a full assessment by a sedation dentist.

The range of treatment available under conscious sedation is limited to basic conservative care and extractions. Endodontic treatment of posterior teeth will not be undertaken. Advanced restorative treatment (including crowns and bridges) will not be provided under IV sedation*.

Patients will be accepted for sedation if the patient:

  • is ASA I, II and III.
  • has moderate to severe dental anxiety.
  • has a gag reflex that limits dental treatment with behaviour management alone.
  • has learning disabilities that reduces the patient’s cooperation with dental treatment.
  • has an involuntary movement disorder that affects the safe provision of dental care.

*exceptions may apply at the discretion of the sedation dentist.

Referred patients who will not receive a consultation appointment for sedation.

Referrals may not be accepted for sedation if the patient:

  • can be best managed by the community dental services.
  • is ASA IV and above.
  • requires intravenous sedation and has no suitable escorts to accompany them to the appointment and look after them post operatively.
  • is pregnant.
  • is referred for endodontic treatment in molar teeth.
  • is referred for crown and bridge work.

Referral forms 

Please refer your patients to our services using one of our referral forms: