Notes For Referring Dentists


The child may need to have a General Anaesthetic to allow treatment because of the following:-

  • A low coping ability
  • Behaviour management problems
  • Dental fear and anxiety
  • White coat syndrome
  • Mental disorder/psychiatric problems

Clinically a child may need a GA for:-

  • Complex operative procedure
  • A high degree of surgical trauma anticipated
  • Severe pulpitis requiring immediate relief
  • Acute soft tissue swelling requiring removal of the infected tooth/teeth
  • Surgical drainage of an acute infected swelling
  • Single or multiple extraction in a young child unsuitable for conscious sedation
  • Symptomatic teeth in more than one quadrant
  • Moderately traumatic or complex extractions e.g. ankylosed or infra-occluded primary molars, extraction of broken-down permanent molars
  • Teeth requiring surgical removal or exposure
  • Biopsy of a hard or soft tissue lesion
  • Debridement and suturing of orofacial wounds
  • Established allergy to local anaesthesia
  • Post-operative haemorrhage requiring packing and suturing
  • Examination under GA, including radiographs, for a special needs child where clinical evidence exists that there is a dental problem which warrants treatment under GA (with prior agreement from the LHB)

(Guidelines for the use of General Anaesthesia (GA) in Paediatric Dentistry. UK National Guidelines in Paediatric Dentistry 2008)


We are the only clinic in South West Wales registered as an Independent Hospital with the Healthcare Inspectorate Wales to carry out General Anaesthesia, thanks to the team lead by Consultant Anaesthetist and Intensivist Dr Push Mangat. He also works at Morriston Hospital, Swansea and joined Parkway in 1999. Dr Philip Majoe and Dr William JY Kwan formed Parkway in 1997 following many years experience and current roles in Anaesthesia in Private and NHS Hospitals.

All our Anaesthetists are Adult Advanced Life Support and Paediatric Advanced Life Support Providers. Our support staffs are also highly trained in these areas.

Please note failure to follow the instructions below may lead to cancellation of your procedure.

Before Your Appointment:

  1. You must not eat or drink anything for at least six hours before your appointment. Keep any meals prior to this light and simple.
  2. Do not chew chewing gum.
  3. Do not smoke for at least 24 hours before the operation and preferably 4-5 days after the operation as it delays healing.
  4. Pregnant ladies will not be treated under general anaesthetic.
  5. A responsible adult must accompany each person being treated and remain in the clinic for the entire time.
  6. You will need to go home in a car or a taxi, not on a bus or train.
  8. You must arrange for someone to look after you for 24 hours after the operation.
  9. Please inform us of any medical conditions you may have before the operation.
  10. You must not bring any other children with you other than the patient.
  11. A child appearing for treatment must not attend school that day.
  12. Patients with any oral/facial cold sores will not be treated until the lesions are healed.

If you have had an immunisation or vaccination in the last 2 weeks prior to your appointment please contact the clinic

At The Appointment:

  1. Please bring any drugs, medicines, tablets or inhalers you use with you.
  2. We advise you to go to the toilet at the clinic immediately after registering at reception.
  3. Do not wear any make up, nail polish or any jewellery.
  4. Do not wear contact lenses.
  5. Please wear loose clothing and sensible low shoes.
  6. Patients under 16 years of age must be accompanied by a parent or legal guardian. Legal guardians must bring written proof of guardianship to the appointment.
  7. Bring any payments which will be needed. We only accept cash, debit and credit cards. We do not accept cheques.

When you arrive you will be met by our receptionist who will check any necessary details and arrange for x-rays to be taken if applicable.

After a short while you will be shown through to the surgery where you will meet the surgeon and the anaesthetist. They will usually ask several more questions and inform you fully about the operation, the general anaesthetic or sedation.

You will be asked to sign a form to consent to the operation. If you have any queries or concerns please direct them to any of our staff.

Your general anaesthetic or sedation will be chosen to ensure a safe operation and rapid recovery. It will usually be administered by intravenous injection. Once you are asleep, accompanying relatives will be asked to leave the operating theatre and wait in the relatives waiting room.

You will wake up in the recovery suite and will be looked after by the recovery nurses. Recovery often takes from 30-60 minutes. You can expect to feel drowsy and slightly sore. Some side effects of the drugs which may be experienced include shivering, muscle soreness, nausea or sickness. You may take mild pain killers as normal afterwards, but not aspirin-based products.

For the first 24 hours after:

  1. Do not drive a car, ride a bike or play sport.
  2. Do not operate machinery (including a cooker) or do anything requiring skill or judgement.
  3. Do not smoke or drink alcohol.
  4. Do not take sleeping tablets.
  5. Do take note of any special instructions given by staff on the day.
  6. Take care if looking after children. Please try to arrange childcare for this period.
  7. Your nose and throat may be sore.
  8. Your neck and shoulders may ache from the anaesthetic.
  9. Warm salt water mouthwashes should be started 24 hours after extractions.
  10. Most stitches, if used, are soluble and will last only a few days. Some will need to be removed 1 week after surgery.
  11. Children should remain home for 24 hours after the operation.


You may bleed from your gums even though you have stitches. Do not panic. Remove loose blood clots. Rinse your mouth once very gently. The blood will clot naturally if you place a firm pack (such as a cotton handkerchief or a corner of a towel) directly over the area and bite down firmly. You should then sit quietly for about 30 minutes. Do not lie down and do not remove the pack.

You may need to try this manoeuvre several times.

If you fail to stop the bleeding or are worried contact us immediately on telephone 01792 455780 (day) or 07000 780424 (evenings and weekends).