Aim and objective: To evaluate the characteristics and treatment modalities performed under general anesthesia in very young children and children with special healthcare needs (SHCN) from January 2016 to December 2018.
Materials and methods: The data was retrospectively collected from the records of the patients who underwent dental rehabilitation under general anesthesia from January 2016 to December 2018. The healthy patients were assigned to group H and children with SHCN were assigned to group S. Comprehensive dental treatment included preventive (oral prophylaxis, fluoride, pit, and fissure sealant), restorations, pulp therapies, and surgical procedures, which were compared.
Results: A total of 46 patients were comprehensively treated under dental general anesthesia (DGA) during the study period. There were 34 males (73.91%) and 12 females (26.08%) with M:F ratio of 2.8:1. The patients in group H were significantly younger than group S. Extraction and restoration were more frequently performed in group S (p < 0.01, p < 0.05). While pulpectomy, pulpotomy, and stainless steel crown (SSC) were more frequently performed in group H (p < 0.01, p < 0.01, p < 0.05).
Conclusion: There was more number of extraction and less number of pulpectomies, pulpotomies, and SSC performed in children with special healthcare needs.
Clinical significance: Dental management of very young children and children with SHCN is a challenging task. DGA is an excellent alternative to undergo full mouth rehabilitation in such patients. Every effort should be made towards restoring oral health of children.
Vinckier F, Gizani S, Declerck D. Comprehensive dental care for children with rampant caries under general anesthesia. Int J Paediatr Dent 2001;11(1):25–32. DOI: 10.1046/j.1365-263x.2001.00204.x
The American Academy of Pediatric Dentistry, “Guideline on behavior guidance for the pediatric dentaln patients. Latest revision 2015. https://www.aapd.org/globalassets/media/policies_guidelines/bp_behavguide.pdf. Accessed: Aug 2020
Dean JA, Avery D, McDonald RE. McDonald and Avery's Dentistry for child and adolescent. Missouri: Elsevier 2016. p. 286–302.
Lee PY, Chou MY, Chen YL, Chen LP, Wang CJ, Huang WH. Comprehensive dental treatment under general anesthesia in healthy and disabled children. Chang GungMed J 2009;32(6):636–642. PMID: 20035643.
Dean JA, Avery D, McDonald RE. McDonald and Avery's Dentistry for child and adolescent. Missouri: Elsevier 2016. p. 513–539.
Altun C, Guven G, Akgun OM, et al.Oral health status of disabled individuals attending special schools. Eur J Dent. 2010;4(4):361–366.
Rajput S, Kumar A, Puranik MP, et al. Oral health inequalities between differently abled and healthy school children in Bengaluru-A cross-sectional study. Spec Care Dentist. 2020;40(1):55–61. DOI: 10.1111/scd.12432
Ibricevic H, Al-Jame Q, Honkala S. Pediatric dental procedures under general anesthesia at the Amiri Hospital in Kuwait. J Clin Pediatr Dent 2001;25(4):337–342. DOI: 10.17796/jcpd.25.4.fl062x558qtt4v69
Bader RM, Song G, Almuhtaseb E. A retrospective study of paediatric dental patients treated under general anesthesia. Int J Clin Med 2013;04:18–23. DOI: 10.4236/ijcm.2013.47A2005.
Brailo V, Janković B, Lozić M, et al. Dental treatment under general anesthesia in a day care surgery setting. Acta Stomatol Croat 2019;53(1):64–71. DOI: 10.15644/asc53/1/7
Manley MC, Skelly AM, Hamilton AG. Dental treatment for people with challenging behaviour: general anaesthesia or sedation? Br Dent J 2000;188(7):358–360. DOI: 10.1038/sj.bdj.4800480
Coyle TT, Helfrick JF, Gonzalez ML, et al. Office-based ambulatory anesthesia: factors that influence patient satisfaction or dissatisfaction with deep sedation/general anesthesia. J Oral Maxillofac Surg 2005;63(2):163–172. DOI: 10.1016/j.joms.2004.10.003
Jamieson LM, Roberts-Thomson KF. Dental general anaesthetic trends among Australian children. BMC Oral Health 2006;6:16. DOI: 10.1186/1472-6831-6-16
Haubek D, Fuglsang M, Poulsen S, et al. Dental treatment of children referred to general anaesthesia–association with country of origin and medical status. Int J Paediatr Dent 2006;16(4):239–246. DOI: 10.1111/j.1365-263X.2006.00737.x
Gadiyar A, Gaunkar R, Kamat AK, et al. Impact of oral health-related behaviors on dental caries among children with special health-care needs in Goa: a cross-sectional study. J Indian Soc Pedod Prev Dent 2018;36(1):33–37. DOI: 10.4103/JISPPD.JISPPD_214_17
Loyola-Rodriguez JP, Zavala-Alonso V, Gonzalez-Alvarez CL, et al. Dental treatment under general anesthesia in healthy and medically compromised developmentally disabled children: a comparative study. J Clin Pediatr Dent 2009;34(2):177–82. DOI: 10.17796/jcpd.34.2.u665328k4g467pg2
Giddon DB, Rudé CM, Belton DE. Psychological problems of the physically handicapped patient. Int Dent J 1975;25(3):199–205.
Vermeulen M, Vinckier F, Vandenbroucke J. Dental general anesthesia: clinical characteristics of 933 patients. ASDC J Dent Child 1991;58(1):27–30.
Jamjoom MM, al-Malik MI, Holt RD, et al. Dental treatment under general anaesthesia at a hospital in Jeddah, Saudi Arabia. Int J Paediatr Dent 2001;11(2):110–116. DOI: 10.1046/j.1365-263x.2001.00252.x
Messieha Z. Risks of general anesthesia for the special needs dental patient. Spec Care Dentist 2009;29(1):21–68. DOI: 10.1111/j.1754-4505.2008.00058.x
Atan S, Ashley P, Gilthorpe MS, et al. Morbidity following dental treatment of children under intubation general anaesthesia in a day-stay unit. Int J Paediatr Dent 2004;14(1):9–16. DOI: 10.1111/j.1365-263x.2004.00520.x
Kwok-Tung L, King NM. Retrospective audit of caries management techniques for children under general anesthesia over an 18-year period. J Clin Pediatr Dent 2006;31(1):58–62. DOI: 10.17796/jcpd.31.1.956272nw2864021p
Holt RD, Chidiac RH, Rule DC. Dental treatment for children under general anaesthesia in day care facilities at a London dental hospital. Br Dent J 1991;170(7):262–266. DOI: 10.1038/sj.bdj.4807504
Moles DR, Ashley P. Hospital admissions for dental care in children: England 1997-2006. Br Dent J 2009;206(7):E14–379. DOI: 10.1038/sj.bdj.2009.254
Harrison MG, Roberts GJ. Comprehensive dental treatment of healthy and chronically sick children under intubation general anaesthesia during a 5-year period. Br Dent J 1998;184(10):503–506. DOI: 10.1038/sj.bdj.4809675
Tsai CL, Tsai YL, Lin YT, et al. A retrospective study of dental treatment under general anesthesia of children with or without a chronic illness and/or a disability. Chang GungMed J 2006;29(4):412–418.
Moskovitz M, Sammara E, Holan G. Success rate of root canal treatment in primary molars. J Dent 2005;33(1):41–47. DOI: 10.1016/j.jdent.2004.07.009
Landes DP, Bradnock G. Demand for dental extractions performed under general anaesthesia for children by Leicestershire Community Dental Service. Community Dent Health 1996;13(2):105–110.
Mallineni SK, Yiu CK. A retrospective review of outcomes of dental treatment performed for special needs patients under general anaesthesia: 2-year follow-up. Sci World J 2014:748353. DOI: 10.1155/2014/748353
Bello L L. A retrospective study of pediatric dental patients treated under general anesthesia. Saudi Dent J 2000;12(1):10–15.