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Alfarraj J, Louise Gray J, Alargan T, Alkathiri M, Alshehri R, Almarwan M. Dental treatment provided to special needs children under general anesthesia in a tertiary care hospital - A cross sectional retrospective study. Saudi Dent J 2024; 36:579-583. [PMID: 38690379 PMCID: PMC11056434 DOI: 10.1016/j.sdentj.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/20/2023] [Accepted: 01/01/2024] [Indexed: 05/02/2024] Open
Abstract
Dental general anesthesia (DGA) can be a preferred approach for treating children with special health needs (CSHCN). It has many benefits, most importantly, the support of the anesthesia team to control the medical status and treat the patient safely. The aim of this study was to evaluate the dental treatment provided to (CSHCN) under (DGA) in a tertiary-care hospital. Moreover, to compare the dental procedures between different medical conditions. This retrospective study involves a sample of 730 children aged between (1-16 years) with complex medical conditions treated under DGA between January 2009 until April 2022. The results show that 4.93 % of these patients had DGA twice. For those children who had DGA only once, the most frequent medical conditions were neuro-developmental disorders (31.8 %), pediatric oncology (17.4 %), and behavioral disorders (autism, ADHD, etc.) (15.1 %). The average age was 6.9 years; almost half were preschool children (4-6 years old, 48.41 %) followed by younger school children (7-9 years old, 28.82 %). The most common dental procedures done were extractions followed by restorative procedures. The use of fissure sealant was significantly higher in neuro-developmental and behavioral disabilities patients than other medical conditions.
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Affiliation(s)
- Jawza Alfarraj
- Pediatric Dentistry Section, Specialized Dentistry Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Jenny Louise Gray
- Dentistry Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Taghreed Alargan
- Pediatric Dentistry Section, Specialized Dentistry Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Reema Alshehri
- Dental Intern, King Saud University, Riyadh, Saudi Arabia
| | - Marwah Almarwan
- Pediatric Dentistry Section, Specialized Dentistry Department, King Fahad Medical City, Riyadh, Saudi Arabia
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Chen R, Schneuer FJ, Irving MJ, Chow CK, Kumar H, Tsai C, Sohn W, Spallek H, Bell J, Nassar N. Socio-demographic and familial factors associated with hospital admissions and repeat admission for dental caries in early childhood: A population-based study. Community Dent Oral Epidemiol 2022; 50:539-547. [PMID: 34837420 DOI: 10.1111/cdoe.12708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/16/2021] [Accepted: 11/10/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Dental caries remains a complex childhood condition often requiring preventable hospital admissions. There are limited population-based epidemiological studies that use large and linked data sets to quantify the clinical, socio-demographic and familial risk factors related to hospital admissions for dental caries. The aim of this study was to describe and quantify the rates, socio-demographic, clinical characteristics and familial factors including repeat admissions associated with young children admitted to hospital for dental caries. METHODS This cohort study (n = 33,438) used longitudinally linked hospital admission data among all children aged <six years in NSW, Australia. Socio-demographic and admission characteristics of children and those with one versus two or more admissions for dental caries were compared. Familial risk factors were analysed for a restricted cohort of families with two or more children (n = 18,174) using multivariable logistic regression to assess the familial factors associated with multiple hospital admissions for dental caries adjusting for other socio-demographic characteristics. RESULTS There were 33,438 children aged <six years who had 34,446 hospital admissions for dental caries between 2001 and 2014. The annual rate of 4.3 per 1000 children remained unchanged over the period. Most admissions required general anaesthesia (96%), and 8.4% of children had repeat admissions. Children living in disadvantaged or in regional and rural areas attending public hospitals were more likely to have dental extractions during the admission. Children from the same family had a 2.7-fold increased odds of admission if the first child admitted was less than three years of age (adjusted odd ratio 2.69; 95% CI: 2.36-3.07), a 1.5 fold increase for socioeconomic disadvantage (aOR 1.45; 1.19 - 1.77) and a 1.9 fold increase of admission if the family had 4 or more children (aOR1.88; 1.47 - 2.42). CONCLUSIONS Findings highlight socio-demographic inequities associated with hospital admission for dental caries. The provision of targeted dental care programs for 'at-risk' families should address these inequalities and presents an opportunity to reduce dental caries related hospitalizations.
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Affiliation(s)
- Rebecca Chen
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, New South Wales, Australia
| | - Francisco J Schneuer
- The University of Sydney, The Charles Perkins Centre, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, New South Wales, Australia
| | - Michelle J Irving
- The University of Sydney, The Menzies Centre for Health Policy, New South Wales, Australia.,Centre for Evidence and Implementation, VIC, Australia
| | - Clara K Chow
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, New South Wales, Australia
| | - Harleen Kumar
- Sydney Dental Hospital and Oral Health Services, Sydney Local Health District, Surry Hills, New South Wales, Australia.,The University of Sydney, School of Dentistry, Faculty of Medicine and Health, New South Wales, Australia
| | - Carrie Tsai
- Sydney Dental Hospital and Oral Health Services, Sydney Local Health District, Surry Hills, New South Wales, Australia.,The University of Sydney, School of Dentistry, Faculty of Medicine and Health, New South Wales, Australia
| | - Woosung Sohn
- The University of Sydney, School of Dentistry, Faculty of Medicine and Health, New South Wales, Australia
| | - Heiko Spallek
- The University of Sydney, School of Dentistry, Faculty of Medicine and Health, New South Wales, Australia
| | - Jane Bell
- The University of Sydney, The Charles Perkins Centre, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, New South Wales, Australia
| | - Natasha Nassar
- The University of Sydney, The Charles Perkins Centre, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, New South Wales, Australia
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Abdo M, Al Halabi M, Hussein I, Salami A, Khamis AH, Kowash M. Characteristics of Pediatric Dental Treatment Provided under General Anesthesia in Dubai, United Arab Emirates: A Retrospective Analysis. Int J Dent 2022; 2022:9900775. [PMID: 37521330 PMCID: PMC10372294 DOI: 10.1155/2022/9900775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/09/2022] [Indexed: 08/01/2023] Open
Abstract
Background Dental general anesthesia (DGA) is a widely utilized technique in pediatric dentistry and is indicated for a variety of cases such as very young children and children with special healthcare needs (SHCN). In the United Arab Emirates (UAE), there is a paucity of studies relating to this subject. Objective To analyze the characteristics of DGA treatment in special healthcare needs and healthy children in the only postgraduate dental hospital in Dubai, UAE. Materials and Methods A retrospective analysis was conducted on the electronic records of all Dubai Dental Hospital (DDH) pediatric patients who underwent DGA in the period between January 1st, 2016, and 29th of February 2020. Results The study population consisted of 98 children. A total of 26 children had a medical condition and were categorized as SHCN. The most common justification for DGA was dental caries and a lack of cooperation due to young age. SHCN patients received significantly more preventive measures and significantly fewer pulp therapies than healthy patients. Conclusion We found that the services provided under DGA for healthy pediatric patients differ from those provided to SHCN patients. Frequently missing recall appointments following DGA increased the likelihood of the need for further restorative dental treatment. These results highlight the importance of robust prevention and follow-up programs for children treated under GA.
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Affiliation(s)
- Mohammad Abdo
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE
| | - Manal Al Halabi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE
| | - Iyad Hussein
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE
| | - Anas Salami
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE
| | - Amar H. Khamis
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE
| | - Mawlood Kowash
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE
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Retrospective Cohort Study on Potential Risk Factors for Repeated Need of Dental Rehabilitation under General Anesthesia in a Private Pediatric Dental Practice. CHILDREN 2022; 9:children9060855. [PMID: 35740792 PMCID: PMC9221647 DOI: 10.3390/children9060855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 12/02/2022]
Abstract
The need for dental rehabilitations under general anesthesia (DRGAs) is continuously increasing, particularly for dental treatment of children. The present retrospective cohort study aimed to investigate potential risk factors for repeated need of DRGA in a cohort of patients from a private pediatric dental practice. Demographic and anamnestic data, dental status, and treatments performed during DRGA were retrospectively analyzed from the electronic dental charts of 1155 children that received at least one DRGA between October 2016 and December 2021. The median age of all children was 5 years at time of their first DRGA. The rate of repeated DRGAs was 9%. Patients with repeated need of DRGA were significantly younger at time of their first DRGA and revealed significantly more often a history of preterm birth and current use of a baby bottle as compared to patients with only one DRGA. There were significantly fewer treatments (regardless of type) in the second DRGA than at the first. Within the limitations of this study, young age at first DRGA, a history of preterm birth, and current use of a baby bottle may be risk factors for repeated need of DRGA. The search for effective strategies to minimize the repeated need for DRGA in children remains critical.
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Dental Treatments under General Anesthesia on Children with Special Health Care Needs Enrolled in the Spanish Dental Care Program. J Clin Med 2021; 10:jcm10020182. [PMID: 33419107 PMCID: PMC7825425 DOI: 10.3390/jcm10020182] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/20/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022] Open
Abstract
The purpose is to analyze the medical characteristics of children with special health care needs (CSHCN) recommended for dental treatment under general anesthesia (GA), postoperative complications, and dental treatment outcomes under the regulation of the Spanish Dental Care Program (PADI). 111 clinical records were selected. The study population was divided into three age groups. The quantitative data was specified as the mean ± SD. For the qualitative variables, the Chi-Square test was used. One-way ANOVA and Bonferroni tests were used to examine the effect of the "age group" and the number of treatment procedures. A total of 1473 treatment procedures were performed, of which 110 (7.5%) were cleanings, 898 (61%) were restorative procedures, 332 (21.7%) were extractions, 22 (1.6%) were endodontic treatments, 62 (4.2%) were pulpotomies, and 59 (4%) were stainless steel crowns. Regarding the mean number of incisor root canal treatments (RCT), age group 3 received a significantly higher mean number of incisor RCTs than age group 1 (p = 0.02). Age group 1 received a higher average of pulpotomies and stainless-steel crowns (p = 0.00) compared to groups 2 and 3. GA is a safe procedure for the dental treatment of CSHCN, with minimal postoperative complications, which should be included among dental public programs.
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