Unravelling referral paths relating to the dental care of children: a study in Liverpool.

OBJECTIVE To describe primary care referral networks relating to children's dental care and the main influences on referral decisions taken by dentists working in a primary care setting. DESIGN A postal questionnaire to all 130 general dental practitioners (GDPs) in contract with Primary Care Trusts (PCTs), and 24 Community Dental Service (CDS) dentists in Liverpool. OUTCOME MEASURES Characteristics of patient groups and factors influencing the choice of referral pathway of children referred from primary dental care. RESULTS There were good responses rates (110 [85%] GDPs and 22 [92%] CDS dentists). The two main reasons why GDPs referred children to hospitals were (a) for treatment under general anaesthetic (GA) or relative analgesia (RA) and (b) for restorative care of dentally anxious children. GDPs also referred anxious children requiring simple restorative care and/or RA to the CDS. Only eight GDPs (7%) cited a lack of experience as a reason for referral of dentally anxious children for simple restorative care, compared to 53 (48%) who cited a lack of RA facilities, and 25 (23%) who cited financial considerations. CONCLUSIONS GDPs refer children to both hospital services and the CDS, and identify a lack of RA facilities and economic pressures as key reasons for referral.