Oral health-related quality of life changes in children following dental treatment under general anaesthesia: a meta-analysis

Comparison of Oral Health-Related Quality of Life scores in children treated for early childhood caries under general and local anesthesia: a quasi-experimental study

PURPOSE

The purpose of this study was to compare the changes in oral health-related quality of life (OHRQoL) scores in children treated for Early Childhood Caries (ECC) under general (GA) and local anesthesia (LA).

METHODS

A quasi-experimental study was carried out on 73 children, with 37 in the GA group and 36 in the LA group. The early childhood oral health impact scale (ECOHIS) was used to measure OHRQoL, with the type of anesthesia (LA or GA) serving as the explanatory variable. A Friedman test was used to assess the difference between the LA and GA groups at baseline, one-week, and one-month follow-up points.

RESULTS

The results showed a significant difference in the overall mean ECOHIS scores between the LA and GA groups at 1-week (LAmean ± SD = 6.12 ± 1.11, GAmean ± SD = 5.50 ± 0.88; P = 0.01) and 1-month (LAmean ± SD = 5.87 ± 1.12, GAmean ± SD = 4.96 ± 0.99; P < 0.001) follow-up points. Irrespective of the administered anesthesia, a significant (P < 0.001) reduction in the mean score for dental pain was observed at both 1-week (mean ± SD = 1.30 ± 1.16) and 1-month (mean ± SD = 0.81 ± 0.89) timepoints after the treatment, as compared to the baseline assessment (mean ± SD = 2.02 ± 1.02).

CONCLUSION

Early treatment for ECC reduces pain, restore normal activities, and improves the quality of life of affected children. Specifically, GA was found to be more beneficial for both children and parents. However, further studies using more robust study designs and carefully considering related factors are necessary to confirm these findings.

Evaluation of Clinical Success, Caries Recurrence, and Oral Health-Related Quality of Life of Children Undergoing Full Mouth Rehabilitation for Early Childhood Caries: A Prospective Cohort Study

AIM

This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management.

METHODOLOGY

The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance.

RESULTS

272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment.

CONCLUSION

Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.

The Effect of the Treatment of Severe Early Childhood Caries on Growth-Development and Quality of Life

PURPOSE

Untreated early childhood caries (ECC) adversely affect children's quality of life. Our aim was to evaluate the effects of ECC on growth, development, and quality of life.

DESIGN AND METHODS

A total of 95 children were divided into three groups: general anesthesia (GA) (n = 31), dental clinic (DC) (n = 31), and control (n = 33). ECOHIS was applied to the parents in the GA and DC groups during a pre-treatment period and also applied in the post-treatment in the first and sixth months. Height, weight, and BMI measurements of the children in the study groups were taken and recorded at the pre-treatment stage and in the post-treatment in the first and sixth months. However, for the control group, these measurements were made just at the baseline and in the sixth month.

RESULTS

Upon the treatment of ECC, the total ECOHIS score significantly decreased (p < 0.001) in both groups in the following first month, whereas the scores of the children in the GA group reached a similar level to the DC group at the end of the sixth month. Following treatment, the weight and height of the children with ECC who initially had significantly lower BMI percentiles than the control group (p = 0.008) were observed to increase and, thus, they reached a similar BMI percentile value to the control group in the sixth month.

CONCLUSIONS

The results of our study revealed that development and growth deficiencies in the children with ECC could be reversed rapidly by dental treatments and, thus, their quality of life would increase. The importance of treating ECC was revealed since treating ECC had positive effects both on the children's growth and development and on the quality of life of the children and their parents.

Assessment of medical practitioners' knowledge about paediatric oral diagnosis and gaze patterns using eye tracking technology

BACKGROUND

Most studies regarding the oral health knowledge of medical practitioners are based on surveys.

AIM

To assess medical practitioners' knowledge in diagnosing and managing children oral health issues using eye tracking technology.

DESIGN

Forty-one medical practitioners completed a cross-sectional survey questionnaire and subsequently viewed 5 clinical images of children's oral cavities to indicate the issues observed and their management. Tobii eye tracking device captured each participant's visual search behaviours and mean length of fixation (LOF) for each area of interest (AOI). Participant self-reported confidence in examining the oral cavity, and qualification level was recorded for data analysis.

RESULTS

No correlation between time spent viewing the soft tissues and self-reported confidence examining the oral cavity was observed (P = .25). Self-reported confidence in examining the oral cavity was not associated with a correct diagnosis. LOF on the decayed teeth was significantly associated with a correct diagnosis of 'caries' (P < .05), and paediatric training was associated with a correct diagnosis of dental caries (P < .05).

CONCLUSION

Medical practitioners' diagnosis and management were poorly correlated with their objective visual search behaviours of the intraoral images. Self-reported confidence in examining and managing oral issues was not correlated with a correct diagnosis, with the majority not confident of examining children oral cavity.

A qualitative analysis of caregiver perceptions of pediatric dental surgery under general anesthesia

BACKGROUND

Dental surgery under general anesthesia (GA) is a common treatment for severe childhood caries and thus may serve as an event to motivate behavior change. The frequency of recurrent caries, however, indicates opportunities within current practice to change a child's oral health behaviors.

AIM

To assess caregiver experiences related to their child's dental surgery to inform development of a behavioral intervention.

DESIGN

Semi-structured interviews with caregivers of children receiving GA for dental surgery. Transcripts (n = 19) were analyzed using qualitative thematic methods.

RESULTS

Children were 2-5 years of age, mean 3.8 years. Limited access to GA services was a source of caregiver frustration and a barrier to caries treatment. Surgical events elicited emotional reactions including guilt, anxiety, and a sense of caregiver accountability for development of severe caries. There was variation in caregiver awareness and/or motivation to change oral health behaviors.

CONCLUSIONS

A child's dental surgery under GA is an emotionally challenging event yet may inspire hope and expectations for improvement. Surgery offers an opportunity to implement interventions at a time when caregivers may be open to assistance with behavior change, though stress and anxiety may create barriers. Behavioral interventions should be tailored to individual caregiver needs/barriers and stage of developmental readiness.

Children and parents perspectives on children's dental treatment under general anesthesia: a narratology from Saskatoon, Canada

Aim

This study aimed to explore the emotional and psychological effects of dental treatment under general anesthesia (DTGA) on children and parents in Saskatoon city, Saskatchewan, Canada.

Design

Semi-structured interviews, video diaries, drawings, and a questionnaire were used to collect data. The study used a narrative perspective and thematic analysis to analyze data.

Results

The findings from children and their parents (N = 25) indicated DTGA is disconcerting from both views. Parental guilt and the desire of both parents and children to not have to go through the experience again fueled at least short-term compliance with brushing, flossing, and changes in dietary habits.

Conclusion

The children participants provided valuable information to augment that gathered from parents. As the study revealed that the DTGA is psychologically and emotionally troubling for both children and their caregivers, it is imperative to explore ways to ease the GA experience. Specific recommendations were provided for optimizing dental and health services for those children and their families.

Sustainability of Improvement in Oral Health-Related Quality of Life in Children After Dental Treatment

PURPOSE

Dental treatment has been associated with improvement in the oral health-related quality of life (OHRQoL) in children. There is little evidence of whether the effect of treatment is sustainable over time or not. The aim of this study was to determine whether the effect of dental treatment on OHRQoL is maintained or diminishes over time.

MATERIALS AND METHODS

A consecutive sample of parents of 47 children between 2 and 6 years who received comprehensive dental treatment at a postgraduate dental clinic were recruited. Parents completed the Early Childhood Oral Health Impact Scale (ECOHIS) prior to treatment and at 1 and 4 months after treatment. Parents were also asked three global questions. Score changes (overall and for each section) between time points were analyzed by a repeated-measures analysis of variance and Bonferroni tests.

RESULTS

The children's mean age was 4.7 ± 1.1, and 60% were females. ECOHIS scores were significantly improved from baseline (22.2 ± 6.9) to 1 month after treatment (8.7 ± 6.8) and were further improved at 4 months after treatment (1.9 ± 2.7), P < 0.001, with large effect sizes (2.8 for the child impact section and 2.2 for the family impact section). Parents' perception of changes in the OHRQoL of their children obtained from a global question indicated an improvement in OHRQoL that was sustained over the follow-up period; at 1-month and 4-month follow-up, 89% and 94% of mothers reported that their child's oral health improved a lot after dental treatment, respectively.

CONCLUSION

The impact of dental treatment on OHRQoL continued to remarkably improve during the 4 months following dental treatment.

A rapid review of variation in the use of dental general anaesthetics in children

Introduction The use of dental general anaesthetics (DGAs) remains a cause for concern due to additional strains placed on health services. There are numerous factors influencing the prevalence and use of DGAs, and understanding these is an important first step in addressing the issue.Aim Conduct a rapid review of current peer-reviewed and grey literature on the variation in the use of DGAs in children.Methods Electronic searching using Medline via Ovid covering DGA articles from 1998 onwards, written in English. Publication types included primary and secondary sources from peer-reviewed journals and reports, as well as grey literature.Results From 935 results, 171 articles were included in the final review. Themes emerging from the literature included discussions of DGA variation, variations in standards of service provision by health services, and the socio-demographic and geographical characteristics of children. Prominent socio-demographic and geographical characteristics included age, other health conditions, ethnic and cultural background, socioeconomic status and deprivation, and geographical location.Conclusions This review identified numerous variations in the patterns associated with DGA provision and uptake at both a health service and individual level. The findings demonstrate the complicated and multifaceted nature of DGA practices worldwide.

Preschool oral health-related quality of life: A practical guide to measurement tools

OBJECTIVE

The purpose of this paper is to describe currently available measurement tools for assessing oral health-related quality of life (OHQoL) in preschool aged children to aid clinicians and researchers in selection of the appropriate tool for their needs.

METHODS

The authors describe and compare eight OHRQoL tools that were created or adapted for use among preschoolers, including the Child Oral Health Impact Profile-Preschool, Dental Discomfort Questionnaire, Early Childhood Oral Health Impact Scale, Michigan-OHRQoL, Parental-Caregiver Perceptions Questionnaire and Family Impact Scale, Pediatric Quality of Life Inventory-Oral Health Scale, Pediatric Oral Health-Related Quality of Life, and Scale of Oral Health Outcomes for 5-year-old children.

RESULTS

The tools vary by their intended target population, oral condition of interest, intended setting for use, and method of administration. They also vary in the number of items or questions included and the domains covered by those items. Unique features and strengths of each are highlighted.

CONCLUSION

A variety of tools exist for measuring OHQoL in preschoolers, this article provides an overview that can facilitate selection for specific intended uses.

COVID-19: implications for paediatric dental general anaesthetic services

Will the coronavirus pandemic bring about change in how we manage children with caries?

Atraumatic restorative treatments improve child oral health-related quality of life: A noninferiority randomized controlled trial

OBJECTIVES

Management of dental caries under dental general anaesthesia (DGA) in young children improves their quality of life. A randomized controlled trial was undertaken to test the changes in oral health-related quality of life among children treated under a DGA or managed using the Atraumatic Restorative Treatment and Hall crown approaches (ARTs).

METHODS

Children scheduled for a DGA for the management of dental caries after assessment at the Oral Health Centre of Western Australia were invited to participate. Inclusion and exclusion criteria were applied. Child oral health-related quality of life (COHRQoL) was evaluated through the Early Childhood Oral Health Impact Scale (ECOHIS) and the child-specific Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) at baseline and 12 months after consent. The changes in child oral health-related quality of life were analysed on an intention-to-treat basis. Paired t-test and Wilcoxon's matched-pairs rank test were used for within-group comparison and t-test, Mann-Whitney test, and test of proportions for between-group comparisons. Linear regression was used for multivariable analyses of the follow-up scores.

RESULTS

Sixty-five parents/carers agreed to participate and were randomized (Test = 32; Control = 33). Mean age = 4.7 years, SD 1.1; 51% male. At baseline, there were no statistically significant differences in age and sex between the groups; however, the ARTs group reported higher ECOHIS scores. At follow-up, both the ARTs and DGA groups had lower ECOHIS scores (20.7 vs 12.9 and 14.4 vs 13.3, respectively) and CARIES-QC scores (12.6 vs 7.1 and 9.9 vs 8.4, respectively). The within-group differences in the ARTs group were statistically significant while the differences in the DGA group were not, P < .01 and P > .05, respectively. In a linear regression of the follow-up scores, being in the DGA group increased the follow-up scores, but it was no longer statistically significant while baseline impact scores were significantly associated with greater follow-up scores for both the ECOHIS and the CARIES-QC, P < .01.

CONCLUSION

The child oral health-related quality life among children scheduled for dental general anaesthesia improved after receiving minimally invasive, atraumatic restorative treatments of dental caries.

Association between body mass index and dental caries in the Kingdom of Saudi Arabia: Systematic review

OBJECTIVE

The Kingdom of Saudi Arabia (KSA) has one of the highest prevalence of both obesity and dental caries. To date, there has not been any documented evidence linking these two factors. Therefore, the objective was to conduct a systematic review of published studies that have analysed the association between body mass index and dental caries in the KSA for both children and adults.

METHODS

A systematic database search [PubMed, EMBASE, Web of Science, CINAHL and Cochrane Library] was conducted following the PRISMA guidelines. The inclusion criteria were observational studies, with no limit on the publication date. Search terms included: dental caries, obesity, overweight, body mass index, BMI 'AND' Saudi Arabia. The independent variable was body mass index (BMI), and the primary outcome measure was dental caries prevalence and severity.

RESULTS

From 951 search results, 935 citations were identified and excluded. Of the 16 potentially eligible studies, two citations were excluded, because the studies did not meet the inclusion criteria. This left fourteen studies meeting the criteria to be included in this systematic review. Ten studies outlined children, and four studies assessed adults. For children, two studies resulted in a positive association between high BMI and caries, six studies resulted in a negative association, and two studies had a non-significant association. For adults, two studies resulted in a positive association between high BMI and dental caries, and two studies had a non-significant association. These were rated as having low to moderate risk of bias.

CONCLUSION

As a result of this equivocal outcome within the systematic review, body mass index and dental caries present as a complex association. Further long-term studies are required to translate the findings into clinical practice.

Efficacy of Alternative Medicaments for Pulp Treatment in Primary Teeth in the Short Term: A Meta-analysis

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the overall, clinical, and radiographical success rates of alternative pulpotomy medicaments in primary teeth.

METHODS

A systematic search of five databases was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Prospective clinical trials using alternative pulpotomy medicaments in children were included. The outcome measures were overall, clinical, and radiographic success, expressed in percentages and converted to odds ratios. Fifteen articles were included in the meta-analysis.

RESULTS

Combined odds ratios for overall, clinical, and radiographic success was 0.55 (95% confidence interval [CI]: 0.12-2.41; P = .42; I² = 76%), 1.03 (95% CI: 0.57-1.86; P = .92; I² = 0%), and 0.84 (95% CI: 0.54-1.47; P = .66; I² = 34%), respectively. The results suggest an inconclusive outcome in the success rate of alternative medicaments.

CONCLUSIONS

There is insufficient evidence to support the efficacy of alternative pulpotomy medicaments for use in primary teeth. Further robust studies are required before such alternative medicaments should be used in clinical practice.

Effects of dental general anaesthesia treatment on early childhood caries: a prospective cohort study in China

OBJECTIVES

To evaluate the success rates of dental procedures, the recurrence rates of caries and changes in oral health-related quality of life (OHRQoL) in children following treatment for early childhood caries (ECC) under dental general anaesthesia (DGA) in Chongqing, China.

DESIGN

A single-centre prospective cohort study conducted from December 2016 to June 2017.

SETTING

A tertiary stomatological hospital in Chongqing, China.

PARTICIPANTS

A total of 159 children aged 2-5 years who received treatment for ECC under DGA were included.

MAIN OUTCOME MEASURES

The primary outcomes were the success rates of dental procedures (the number of successful procedures divided by the total number of procedures) and the recurrence rates of caries. The success and recurrence rates were evaluated by a specialised examiner. The secondary outcome was the change in children's OHRQoL after DGA treatment, which was measured with the Early Childhood Oral Health Impact Scale (ECOHIS).

RESULTS

Overall, 117 children (73.6%) and 101 children (63.5%) participated in 6-month and 12-month clinical examinations, respectively, and 151 children (95.0%) completed OHRQoL surveys pretreatment and at 1, 3, 6 and 12 months post-treatment. The resin composite, stainless steel crown, indirect pulp capping, pulpectomy, space maintenance and dental sealant success rates were 89.6%, 96.3%, 96.0%, 94.4%, 76.9% and 92.9%, respectively, at 6 months and 78.8%, 95.1%, 92.2%, 88.9%, 63.6% and 89.3%, respectively, at 12 months. 10 (8.5%) and 19 children (18.8%) developed recurrent caries within 6 and 12 months, respectively. Within 1 year of treatment, the total ECOHIS scores at each post-treatment time point were still significantly lower than those at pretreatment, although they had increased slowly over time.

CONCLUSIONS

Overall, high success rates were obtained for the dental procedures, and the children's OHRQoL significantly improved after treatment. However, there was a tendency towards caries relapse, and the children's OHRQoL deteriorated over time.

OHRQoL changes among Chinese preschool children following dental treatment under general anesthesia

OBJECTIVE

To assess dental treatment under dental general anesthesia (DGA) among Chinese preschool children by investigating changes in their oral health-related quality of life (OHRQoL), the incidence of postoperative complications, and parental satisfaction.

METHOD

A single-center prospective cohort study was conducted. A total of 190 children who received treatment for early childhood caries (ECC) under DGA were included. The primary outcome was a change in the children's OHRQoL at 1 month after the operation compared to that at baseline, which was measured by the Early Childhood Oral Health Impact Scale (ECOHIS). The secondary outcomes were the incidence of complications within 1 day after treatment and parental satisfaction with the DGA treatment.

RESULTS

In total, 180 participants were successfully reevaluated after the operation, yielding a 94.7% follow-up response rate. The total ECOHIS score decreased by 76.3% (P < 0.01) after treatment, demonstrating a large effect. Approximately 74.4% of the children complained of at least one complication, including sleepiness (43.3%), emergence agitation (38.9%), nausea/vomiting (13.9%), dizziness (10.6%), and fever (3.3%), on the first day. Approximately 85.5% of the parents were satisfied with the DGA treatment.

CONCLUSION

DGA treatment has a positive effect on Chinese preschool children's OHRQoL and is evaluated highly by their parents.

CLINICAL RELEVANCE

Dental treatment under general anesthesia improved the OHRQoL of Chinese preschool children.

Effects of restoring SDF-treated and untreated dentine caries lesions on parental satisfaction and oral health related quality of life of preschool children

OBJECTIVES

To find out the effects of placement of atraumatic restorative treatment (ART) restorations on parental satisfaction and oral health related quality of life (OHRQoL) of preschool children with SDF-treated or untreated dentine caries lesions.

METHODS

In a randomized controlled trial conducted in Hong Kong, preschool children who had cavitated dentine caries lesions were randomly assigned to receive application of silver diamine fluoride (SDF) solution or placebo (tonic water) on their caries lesions 10 weeks before receiving ART restorations. Parents were asked to rate their satisfaction with their child's teeth using a 5-point scale (5 = very satisfied, 1 = very dissatisfied) before and six months after the restorative treatment. Besides, the Chinese version of Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to assess the children's OHRQoL.

RESULTS

A total of 194 children participated in this study, with 101 and 93 children receiving SDF and placebo application before ART restorations, respectively. There was no significant difference in parental satisfaction and C-ECOHIS score between the SDF and placebo groups at baseline. At the 6-month follow-up, the mean parental satisfaction score regarding their child's dental health status increased significantly (p < 0.001) from 2.2 ± 0.7 to 2.8 ± 1.0 in the SDF group and from 2.3 ± 0.8 to 2.7 ± 0.9 in the placebo group. However, no significant changes (p > 0.05) in C-ECOHIS scores were found in either of the two groups after ART restoration placement.

CONCLUSIONS

Placement of ART restorations can improve parental satisfaction with the health and appearance of their child's teeth but has no significant effect on the OHRQoL.

CLINICAL SIGNIFICANCE

This study provides valuable information about the effects of ART restoration placement on SDF-treated or untreated dentine caries lesions regarding parental satisfaction and OHRQoL of preschool children.

Responsiveness of Oral Health-Related Quality of Life Questionnaires to Dental Caries Interventions: Systematic Review and Meta-Analysis

This systematic review and meta-analysis were undertaken to assess the responsiveness of validated oral health-related quality of life (OHRQoL) questionnaires to dental caries interventions in children, adolescents, and young adults. Studies eligible were randomized clinical trials (RCTs), controlled clinical trials (CCTs), and prospective case series (PCS), which had OHRQoL questionnaires answered before and after caries intervention(s). The main outcome was improvement in OHRQoL mean scores following caries intervention. Twenty-six studies were selected for the quality assessment and 14 were selected for the meta-analysis. Most of the studies were PCS with a single group pretest and posttest study design (n = 19). Five studies were CCT and only 2 were RCT. The numbers of participants were 3,522 in the control group (baseline = 2,002; final = 1,520) and 5,917 in the test group (baseline = 3,102; final = 2,815). The age of the subjects ranged from 3 to 19 years. All studies showed significant improvement in OHRQoL following caries intervention. Most of nonrandomized studies (n = 15) had low or moderate risk of bias. The meta-analysis showed the effect of caries interventions (standardized weighted mean differences = -1.24; 95% CI: -1.68 to -0.81; p < 0.001). However, high heterogeneity between the studies was found. The Grading of Recommendations Assessment, Development and Evaluation approach classified the quality of evidence as very low and its strength weak. In conclusion, there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures, but the quality of the evidence was very low. In spite of that, caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of OHRQoL.

Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective

BACKGROUND

This paper is a summary of the proceedings of the International Association of Paediatric Dentistry Bangkok Conference on early childhood caries (ECC) held in 3-4 November 2018.

AIM

The paper aims to convey a global perspective of ECC definitions, aetiology, risk factors, societal costs, management, educational curriculum, and policy.

DESIGN

This global perspective on ECC is the compilation of the state of science, current concepts, and literature regarding ECC from worldwide experts on ECC.

RESULTS

Early childhood caries is related to frequent sugar consumption in an environment of enamel adherent, acid-producing bacteria in a complex biofilm, as well as developmental defects of enamel. The seriousness, societal costs, and impact on quality of life of dental caries in pre-school children are enormous. Worldwide data show that ECC continues to be highly prevalent, yet infrequently treated. Approaches to reduce the prevalence include interventions that start in the first year of a child's life, evidence-based and risk-based management, and reimbursement systems that foster preventive care.

CONCLUSIONS

This global perspective on ECC epidemiology, aetiology, risk assessment, global impact, and management is aimed to foster improved worldwide understanding and management of ECC.

The family impact of dental general anaesthesia in children: A meta-analysis

BACKGROUND

The health and well-being of children are intimately linked to their parents' physical, emotional, and social health and social circumstances.

AIM

To conduct a meta-analysis of studies that have used the Early Childhood Oral Health Impact Scale (ECOHIS) and Child Oral Health-Related Quality of Life (COHRQoL) instruments, to evaluate the family impact scale (FIS) changes following their children's dental treatment under general anaesthesia (DGA).

METHODOLOGY

A systematic search was undertaken using the PRISMA guidelines. The inclusion criteria consisted of patients below 16 years of age, DGA, pre- and post-operative assessments, and the use of ECOHIS and COHRQoL. FIS changes were the primary outcome measure, where the mean difference (MD) was calculated.

RESULTS

After initial search of 105 studies in the database, twenty-one articles were included in the analysis. A positive outcome in the FIS changes was identified in all studies. The combined MD for FIS using ECOHIS and COHRQoL was 1.52 [95% CI: 1.15-1.89; P < 0.00001; I2 =87%] and 1.10 [95% CI: 0.68-1.52; P < 0.00001; I2 =79%], respectively.

CONCLUSIONS

Dental treatment with general anaesthesia for children had a significant positive impact on parental emotions, activity, and conflict. Following DGA, there was significant improvement in the FIS, with large MD.