Dentists to stop giving general anaesthetic

Dentists are to be banned from administering general anaesthetics to patients in their surgeries from January 2002, because of a series of deaths, mainly among children, the Government's chief medical officer announced yesterday.

Dentists are to be banned from administering general anaesthetics to patients in their surgeries from January 2002, because of a series of deaths, mainly among children, the Government's chief medical officer announced yesterday.

Liam Donaldson said repeated efforts to ensure general anaesthetics were given safely in dental surgeries, backed by millions of pounds of government money, had failed. The Government had come to the view, therefore, that the only safe place to administer them was in hospital.

The decision means tens of thousands of patients who are nervous or phobic about the dentist and need a general anaesthetic will have to be treated in a hospital. Surgeries are to be encouraged to offer other forms of sedation, such as an injection of the tranquilliser Valium, which do not put patients to sleep.

The British Dental Association warned that patients could be put off going to the surgery unless they were reassured their anxiety could be controlled. "Unless they can be sedated they are unlikely to seek treatment at all," it said.

Recent figures show that 57,000 general anaesthetics were administered in dental surgeries last year, more than three-quarters of them to children. The total is down from 300,000 in the mid-Nineties, and from more than a million in the mid-Seventies, as alternative methods of sedation have increasingly been used.

Professor Donaldson, who is launching a report A Conscious Decision on the use of general anaesthesia by dentists, said there were eight deaths in dental practices from 1996 to 1999, five of them in children. "There has been a great deal of concern about these deaths. They have been tragedies for the families involved and this was uppermost in the committee's mind," he said.

One of the children was Katie Dougal, 10, of Breaston in Derbyshire, who was taken to the dentist by her mother in January 1996 after a school playground fall in which she broke two front teeth. She was given a general anaesthetic by Dr Tapas Kumar Basu, an anaesthetist assisting the dentist, Mark Duckmanton, at his surgery in Long Eaton. Dr Basu was later found guilty of serious professional misconduct by the General Medical Council for failing to monitor the child's heart rate and carbon dioxide level.

Professor Donaldson said there had only been seven years in the last 35 when a death had not occurred. Three dentists are due to appear before the General Dental Council on Monday in relation to the death of a patient in Scotland.

The ban could not be brought in until arrangements had been made to provide general anaesthetics in hospital, but tougher inspections and standards would be applied in the interim, Professor Donaldson said.

The Government had decided to act after a review of the Poswillo report in 1990, which recommended improvements in the way anaesthetics were given and which was backed by £20m of government money, found its implementation was "inconsistent".

Robin Wild, the chief dental officer, said: "We were very conscious of the great personal tragedy of so many children dying in the dentist's chair unnecessarily. That was our guiding principle."