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Sir, as a Past President of the BDA I am dismayed and bemused to read frequent reports in national newspapers decrying the number of children awaiting many months for tooth extractions in
hospitals. Indeed, the _Daily Telegraph_ claims that this is the most frequent referral cause for children to hospital, numbering equating to 177 cases per day nationally at an estimated
cost of £41 million. A further report of this problem appears in the recent _BDJ_ (_Potential surge in post-COVID child tooth_ _extractions_; _BDJ _2020; 229: 278)_. _ Is this because
dentists, both in practices and community dental services, are either unwilling or unable to perform this treatment? Furthermore, it seems that frequent courses of antibiotics are prescribed
to keep infection from carious teeth at bay pending hospital extraction. As we are all too aware, this repeat prescribing is undesirable, building up unnecessary resistances. I presume
dental schools still educate undergraduates in the expert technique of extractions, therefore one must conclude that the problem is due to an unwillingness of clinicians in primary care to
undertake these treatments. We must remember that for every child suffering from painful teeth, there are parents having to cope with stressful situations. Many years ago, I was a member of
the then termed 'Poswillo' working party, reporting to the Department of Health on the safety of administering general anaesthetics (GA) in practices, but additionally our role
included reviewing other means of anaesthesia. Whilst not advocating a return to providing GAs in outpatient clinics, in a primary care setting it is perfectly possible and permissible to
extract offending teeth using either sedation or local anaesthesia or a combination of both. As healthcare professionals, dentists have a duty to relieve pain and to prevent the risk of
complications arising from long-term infections rather than referring patients to a seemingly endless waiting list, especially during these difficult COVID-19 times, which is exacerbating
this dire state of affairs. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * By email, York, UK J. Stuart Robson Authors * J. Stuart Robson View author publications You can also search for this
author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Robson, J. Duty to extract. _Br Dent J_ 229, 499 (2020).
https://doi.org/10.1038/s41415-020-2282-3 Download citation * Published: 23 October 2020 * Issue Date: October 2020 * DOI: https://doi.org/10.1038/s41415-020-2282-3 SHARE THIS ARTICLE Anyone
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