Declining attendances for general anaesthesia and tooth extractions in children following the fluoridation of Melbourne

Utilization of day stay general anaesthesia for the provision of dental treatment to children in New South Wales, Australia

OBJECTIVES

To assess the demand for paediatric dental general anaesthetic services at a specialist paediatric dental unit in Australia and to evaluate the changing pattern of general anaesthetic use in children at this unit over the past decade.

METHODS

A retrospective review of hospital records of a random sample of children receiving dental treatment under general anaesthesia during the years 1984 and 1996. Demographic and clinical data was collated and analysed using SPSS for Windows.

RESULTS

The number of children managed under general anaesthesia increased from 189 in 1984 to 777 in 1996. This was accompanied by an increase in the time the patients waited for treatment. There was little difference in the mean age of the patients with over two-thirds of the children being under the age of 6 years. Whilst children of Anglo-Saxon origin accounted for the majority of patients across the 13-year period there was a significant increase in the number of children from Asian or Middle Eastern backgrounds. A disproportionate number of these children accessed the services as self-referrals. Caries remained the most common reason for referral, with trauma and dental anomalies accounting for less than 10%.

CONCLUSIONS

Despite the general decline in dental caries there remain an important group of young children who have high treatment needs and for whom general anaesthesia provides a useful treatment option. Preventive strategies should be targeted towards these groups of children.

Diet and feeding patterns in high risk pre-school children

A survey of 60 pre-school children both from Anglo-Saxon and Lebanese backgrounds collected detailed information on subjects' oral health status and dietary and feeding habits. Lebanese subjects had significantly higher caries experience (mean dmfs = 4.88) than Anglo-Saxon subjects (mean dmfs = 0.56). Subjects from the different backgrounds varied significantly also in the frequency of exposure to cariogenic agents and health practices. In each situation Lebanese children were exposed to higher risk factors than Anglo-Saxon children. Notwithstanding the association between variables, the best single predictor of variance in caries experience of subjects, explaining 23 per cent of the variance of dmfs, was the mother's level of education. Culturally relevant health education programmes need to address the specific requirements of high risk groups.