LAUSR

The 2019 National Epidemiological Survey indicated that 23.4% of 5yearolds in England had an experience of dental decay.1 Between 40% and 45% of these visibly decayed teeth in highrisk children will develop pain and infection regardless of the treatment plan.2 Treatment in children is challenging and, in some cases, impossible without general anaesthesia (GA). In North Cumbria, children attend for exodontia under GA on lists planned and staffed by the Community Dental Services (CDS). In this area, there is no specialist nor consultant in paediatric dentistry; therefore, treatment planning support is provided by colleagues in orthodontics, in special care dentistry and from out of the county. Extraction under GA is usually indicated due to unrestorable caries but, in some cases, due to symptomatic hypomineralisation, malpositioned or supernumerary teeth. This audit was undertaken in a relatively remote CDS serving Carlisle and Eden, where the national epidemiological surveys point to 25.5% and 23.3%, respectively, of 5yearolds with visible dental decay, which is above the national average.1 Prevention for children who are classed as high caries risk is important and forms the foundation for treatment planning.3– 5 Fluoride varnish is a wellaccepted, affordable and effective method for preventing dental caries.