Follow-up of children's oral health-related quality of life after dental general anaesthesia treatment

Evaluation of oral health-related quality of life following dental rehabilitation under general anesthesia in Turkish children with early childhood caries

BACKGROUND

Early childhood caries (ECC) is one of the most common dental problems, which often require dental rehabilitation with general anesthesia (DRGA).

AIM

To assess the short- and long-term effects of DRGA on children and their families' oral health-related quality of life (OHRQoL) in preschool children, the incidence of complications on the first day, and the factors affecting them and parental satisfaction.

DESIGN

A total of 150 children treated for ECC under DRGA were included in the study. OHRQoL was assessed on the day of DRGA, 4 weeks, and 1 year after treatment using the Early Childhood Oral Health Impact Scale (ECOHIS). The incidence of complications and parental satisfaction with DRGA were evaluated. The data were analyzed for statistical significance (p < .05).

RESULTS

In total, 134 patients were re-evaluated at the end of the fourth week and 120 at the end of the first year. The average ECOHIS scores before and after DRGA (4 weeks and 1 year) were 18.1 ± 8.5, 3.1 ± 3.9, and 5.9 ± 6.2, respectively. After DRGA, 29.2% of the children reported at least one complication. Ninety-one percent of the parents reported that they were satisfied with DRGA.

CONCLUSION

DRGA has a positive effect on the OHRQoL of Turkish preschool children with ECC and is highly evaluated by their parents.

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.

Perceived Outcomes, Parental Satisfaction, and Oral Health-Related Quality of Life After Full Mouth Rehabilitation Under General Anesthesia for Early Childhood Caries

AIM

The aim of this article is to evaluate the perceived outcomes, parental satisfaction, and oral health-related quality of life after full mouth rehabilitation under general anesthesia for children with early childhood caries.

MATERIALS AND METHODS

A total of 200 children requiring full-mouth rehabilitation under general anesthesia for the management of early childhood caries were recruited for the study. Perceived outcomes, oral health-related quality of life, and parental satisfaction were evaluated at the follow-up visit after six months.

RESULTS

All participants reported back for the follow-up visit after six months. Oral health-related quality of life after full-mouth rehabilitation showed statistically significant improvement at follow-up (P <0.001); 97.5% of the parents were satisfied with the treatment. Perceived outcomes were found to be satisfactory, and a significant improvement (P <0.001) was seen after treatment.

CONCLUSION

The perceived outcomes of participating parents were met. Significant improvement in oral health was seen after full-mouth rehabilitation under general anesthesia. Parental satisfaction was found to be high at the follow-up visit after six months. Parents found the improvement in the oral and general health of their child to be significant.

The Evaluation of Postoperative Complications and Oral Health-Related Quality of Life Following Dental General Anesthesia for Early Childhood Caries

Aim The study aims to evaluate the postoperative complications and oral health-related quality of life (OHRQoL) following dental general anesthesia for early childhood caries (ECC). Materials and methods Two hundred children aged between three and six requiring full-mouth rehabilitation for general anesthesia were recruited for the study. Demographic data and oral health-related quality of life using the Early Childhood Oral Health Impact Scale (ECOHIS) were collected before the surgery. Postoperative complications and oral health-related quality of life were evaluated after 24 hours and at a one-week follow-up appointment. Results All 200 children returned for the follow-up appointment after one week. Pain was found to be the most common postoperative complication after 24 hours (52%) and one week (6%). The oral health-related quality of life showed a significant improvement after one week (P < 0.001) Conclusion Children may experience a postoperative complication after full-mouth rehabilitation, which resolves within a week. Dental pain was the most common operative complication in the present study. Oral health-related quality of life showed significant improvement after full-mouth rehabilitation.

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.

Parental and Child Outlook on the Impact of ECC on Oral Health-related Quality of Life: A Prospective Interventional Study

AIM

To evaluate the perspectives of parents and children on the impact of early childhood caries (ECC) on the oral health-related quality of life (OHQoF).

MATERIALS AND METHODS

About 400 children aged 3-5 years were recruited for the study. About 200 children who were caries-free were the controls for the study. The remaining 200 consisted of children who were diagnosed with ECC and required dental rehabilitation under general anesthesia. Oral health-related quality of life was recorded at baseline and 6 months after intervention using the Michigan oral health-related quality of life scale. Data were analyzed and evaluated using Statistical Package for Social Sciences (SPSS) Version 25.0.

RESULTS

Children with ECC were found to have a significantly lower oral health-related quality of life compared with caries-free children, and a statistically significant difference was seen between both groups. The main concern for both parents and children at baseline was pain at the first visit when the evaluation was done. After the intervention, a significant improvement in the oral health-related quality of life was seen.

CONCLUSION

Early childhood caries was found to have detrimental effects on the oral health-related quality of life. Full-mouth rehabilitation under general anesthesia was found to bring a significant improvement in the oral health-related quality of life. The perspectives of both parents and children were found to be similar.

CLINICAL SIGNIFICANCE

Early childhood caries has an impact on the lives of children and their parents. Oral health-related quality of life was low with children suffering from ECC. Full-mouth rehabilitation under general anesthesia can significantly improve the OHRQoL of children. Continuous monitoring of the children with regular follow-ups and parental education should be enforced to prevent the relapse of ECC.

Oral Health-related Quality of Life of Children with Early Childhood Caries before and after Receiving Complete Oral Rehabilitation under General Anesthesia

Introduction

Early childhood caries (ECC) significantly affects the quality of life of children due to recurrent pain, infection, and other associated problems.

Aim and objective

To assess the change in oral health-related quality of life of children aged <5 years undergoing complete oral rehabilitation under general anesthesia.

Materials and methods

A total of 50 healthy children affected with ECC were enrolled for the present study. Oral health-related quality of life (OHRQoL) of every child was assessed by interviewing the mothers using a prevalidated Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire one day prior to the treatment appointment and comparing the scores with those at 1 and 3 months post-treatment to evaluate the changes in the OHRQoL, if any and assess the stability of the changes.

Results

The results revealed a statistically significant reduction in Ouality of Life (QoL) scores of all the domains and total ECOHIS scores between baseline and 1 month, and baseline and 3 months. Conclusion: The oral health-related quality of life showed a significant improvement after complete oral rehabilitation under general anesthesia and the improvement persisted beyond the immediate post-treatment period.

How to cite this article

Raghu R, Gauba K, Goyal A, et al. Oral Health-related Quality of Life of Children with Early Childhood Caries before and after Receiving Complete Oral Rehabilitation under General Anesthesia. Int J Clin Pediatr Dent 2021;14(S-2):S117–S123.

Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania

OBJECTIVES

This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries.

METHODS

The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC-OF-14). Of 176 mothers, 123 (69.9%) took part in the 2016-2017 study. The self-administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi-squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences).

RESULTS

Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28-6.63]; p = .005). We observed significant associations among mothers who gave their children sugar-sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59-27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99-15.18]; p = .05).

CONCLUSIONS

A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.

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.

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.

Dental management of a child with ectrodactyly ectodermal dysplasia cleft lip/palate syndrome: A case report

Ectrodactyly ectodermal dysplasia with clefting is a rare syndrome resulting from TP63 gene mutations. It is inherited in autosomal dominant manner or as a de novo transfiguration. It is characterized by a triad of ectodermal dysplasia, ectrodactyly, and facial clefts. This report represents a clinical case of 5 years and 6 months-old male child with ectrodactyly ectodermal dysplasia cleft lip and palate syndrome requiring treatment of his carious teeth. After history taking and clinical examination, the necessary treatment was provided under general anesthesia due to the definitely negative behavior of the child. The treatment outcomes had a positive impact on the behavior and acceptance to dental treatment. This was evidenced by completion of the prosthetic and space management appliances on the dental chair. The child's quality of life was consequently improved. This was evidenced by the reduced response scores of the child perception questionnaire (CPQ_11-14 ) after treatment. This report highlighted the value of proper diagnosis and fulfillment of the unmet dental needs for patients with orofacial syndromes to improve their quality of life.

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.

Validation of the Spanish version of the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire

Background

The Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHC-OHRQOL-Q) is an instrument designed specifically for parents and caregivers of patients with special needs that has not yet been applied in Spain. The aim of this study was to adapt it to Spanish and evaluate its reliability and validity in patients with intellectual disability (ID) treated under general anesthesia.

Material and Methods

The study was conducted in two different stages: a) cross-cultural adaptation of the original questionnaire, and b) cross-sectional study on 100 parents and caregivers who completed the piloted FHC-OHRQOL-Q. The patients were examined according to the WHO methodology. Dental treatments performed were recorded. Statistical tests were used to evaluate reliability (internal consistency) and validity (content, criterion, construct and discriminant) of the instrument.

Results

The mean age was 24 years (range=4-71 years). The most frequent causes of ID were psychomotor retardation (25%) and cerebral palsy (24%). The items most frequently answered by parents and caregivers were eating and nutrition problems (80%) and bad breath/taste (57%). Reliability (Cronbach’s alpha coefficient) was considered excellent (alpha=0.80-0.95). The analysis of the factorial validity yielded similar results to the original questionnaire. The high response rate of items (>96%) allowed content validity. Criterion validity was confirmed by a significant correlation with questions on oral health and oral well-being. Discriminant validity was demonstrated by the significant association of ≥21.5 years of age with worse oral symptoms (p=0.034) and parental concerns (p=0.005), DMFT index ≥3 with daily life problems (p=0.02), ≥4 decayed teeth with daily life problems (p=0.001), and >2 dental extractions with oral symptoms (p=0.000), daily life problems (p=0.002) and parent´s perceptions (p=0.043).

Conclusions

The FHC-OHRQOL-Q in Spanish is a reliable and valid instrument to apply in clinical practice to evaluate the impact of OHRQOL in mostly adult patients with ID, accessible to Spanish-speaking parents and caregivers.

Key words:Oral health-related quality of life, intellectual disability, cross-cultural validation, psychometric properties, validation, questionnaire.

Severe caries are a clue for child neglect: a case report

Background

Child abuse and neglect have strong negative effects on the well-being of children, not only during childhood but also later in life. Therefore, early recognition is important.

Case presentation

We describe a 4-year-old Caucasian boy who had severe dental caries. This was a result of insufficient dental care: he refused to brush his teeth and drank sweetened drinks. We considered this dental neglect to be a manifestation of child neglect and social services were consequently called in to help the family.

Conclusions

There is a strong association between child abuse and neglect and dental caries. Abused children often have severe dental caries and in children who had dental caries, child abuse and neglect is often established. An important factor is insufficient parenting; therefore, we believe that severe dental caries is an important indicator for child abuse and neglect.

Behavioral regression in 2 patients with autism spectrum disorder and attention-deficit/hyperactivity disorder after oral surgery performed with a general anesthetic

BACKGROUND AND OVERVIEW

Routine dental care for people with autism spectrum disorders can be complex. There is little published on postoperative behavioral changes associated with use of general anesthetics in this population.

CASE DESCRIPTION

The authors describe postoperative behavioral changes in 2 patients with autism spectrum disorder and attention deficit hyperactivity disorder that the patients' caretakers described as regression. In both cases, behaviors representative of autism spectrum disorder and attention deficit hyperactivity disorder worsened after uncomplicated oral surgery after receipt of a general anesthetic in the operating room. In both cases, behavioral changes caused great difficulties for the patients and caretakers and were difficult to address.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

With little in the scientific literature, these 2 cases have a great importance for the dental care practitioner. Awareness must be raised so that further investigation can occur regarding this phenomenon.