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Ma SY, Zhou QN, Cai S, Zhou Y, Zhang XY, Feng XY, Diao S, Xi JQ, Yu GX, Shang JJ, Yang NY. A comparative study of microbial changes in dental plaque before and after single- and multiappointment treatments in patients with severe early childhood caries. BMC Oral Health 2024; 24:695. [PMID: 38879477 PMCID: PMC11179330 DOI: 10.1186/s12903-024-04458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/07/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND The status of dental caries is closely related to changes in the oral microbiome. In this study, we compared the diversity and structure of the dental plaque microbiome in children with severe early childhood caries (S-ECC) before and after general anaesthesia and outpatient treatment. METHODS Forty children aged 3 to 5 years with S-ECC who had completed whole-mouth dental treatment under general anaesthesia (C1) or in outpatient settings (C2) were selected, 20 in each group. The basic information and oral health status of the children were recorded, and the microbial community structure and diversity of dental plaque before treatment (C1, C2), the day after treatment(C2_0D), 7 days after treatment (C1_7D, C2_7D), 1 month after treatment (C1_1M, C2_1M), and 3 months after treatment (C1_3M, C2_3M) were analysed via 16 S rRNA high-throughput sequencing technology. RESULTS (1) The alpha diversity test showed that the flora richness in the multiappointment group was significantly greater at posttreatment than at pretreatment (P < 0.05), and the remaining alpha diversity index did not significantly differ between the 2 groups (P > 0.05). The beta diversity analysis revealed that the flora structures of the C1_7D group and the C2_3M group were significantly different from those of the other time points within the respective groups (P < 0.05). (2) The core flora existed in both the pre- and posttreatment groups, and the proportion of their flora abundance could be altered depending on the caries status of the children in both groups. Leptotrichia abundance was significantly (P < 0.05) lower at 7 days posttreatment in both the single- and multiappointment groups. Corynebacterium and Corynebacterium_matruchotii were significantly more abundant in the C1_1M and C1_3M groups than in the C1 and C1_7D groups (P < 0.05). Streptococcus, Haemophilus and Haemophilus_parainfluenzae were significantly more abundant in the C1_7D group than in the other groups (P < 0.05). CONCLUSION A single session of treatment under general anaesthesia can cause dramatic changes in the microbial community structure and composition within 7 days after treatment, whereas treatment over multiple appointments may cause slow changes in oral flora diversity.
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Affiliation(s)
- Shi Ying Ma
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
- Department of Pediatric Dentistry, Stomatological Hospital affiliated Suzhou Vocational Health College, Suzhou, 215000, China
| | - Qing Nan Zhou
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Shuang Cai
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Yan Zhou
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Xiao Yu Zhang
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Xiao Yu Feng
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Shu Diao
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Jin Qiu Xi
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Guo Xia Yu
- Department of Stomatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jia Jian Shang
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China.
| | - Ning Yan Yang
- Department of Pediatric Dentistry, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing, 100050, China.
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Pratyaprateep N, Jirarattanasopha V, Smutkeeree A. Dental treatment outcomes in Thai children treated for severe early-childhood caries under general anaesthesia and non-pharmacological behaviour management: a retrospective study. Eur Arch Paediatr Dent 2024; 25:349-358. [PMID: 38789912 PMCID: PMC11233317 DOI: 10.1007/s40368-024-00887-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/28/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE The aim of this study was to compare dental-treatment outcomes, oral-hygiene improvement, and patient co-operation during follow-up visits between children treated under general anaesthesia (GA) and non-pharmacological behaviour management (NP). METHODS This retrospective study reviewed the dental chart records of healthy patients less than 71-month-old with severe early childhood caries (S-ECC) from 2008 to 2020 with at least a 6-month follow-up. The demographical data, dental-treatment outcomes, oral-hygiene status, and patient behaviour at the follow-up visits were analysed by the Mann-Whitney U test, Pearson's Chi-square, Fisher's exact test, Friedman test, and Wilcoxon test with a significance level of 0.05. RESULTS This study included 210 GA cases and 210 age-matched control NP cases. The GA group had a significantly higher caries experience, lower patient co-operation, poorer oral hygiene, and higher number of complex dental treatment than the NP group at baseline (p < 0.001). The number of children who had incomplete dental treatment under non-pharmacological behaviour management was higher than the GA group. After treatment, the number of new carious teeth in the NP group was significantly higher than in the GA group only at the 6-month follow-up. However, there was no significant difference in treatment failure, oral-hygiene improvement, and patient behaviour between groups. CONCLUSION Although patients in the GA group had higher dental and behaviour problems than the NP group, the overall dental-treatment outcomes, including oral hygiene and behaviour improvement, were not significantly different between groups Therefore, regular follow-up and preventive treatment in the maintenance phase are essential for children with severe early-childhood caries.
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Affiliation(s)
- N Pratyaprateep
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Rd, Ratchathewi, Bangkok, 10400, Thailand
| | - V Jirarattanasopha
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Rd, Ratchathewi, Bangkok, 10400, Thailand
| | - A Smutkeeree
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Rd, Ratchathewi, Bangkok, 10400, Thailand.
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Alwadani MA, Alsulaiman DA, Kakti A, Alamoudi S, Tadakamadla SK, Quadri MFA. 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. Eur Arch Paediatr Dent 2023; 24:719-728. [PMID: 37644356 DOI: 10.1007/s40368-023-00835-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
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.
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Affiliation(s)
- M A Alwadani
- Jazan Specialized Dental Center, Ministry of Health, Riyadh, Saudi Arabia
| | | | - A Kakti
- Department of Pediatric Dentisty, Riyadh Elm University, Riyadh, Saudi Arabia
| | - S Alamoudi
- Pediatric Dentistry, Al-Iman General Hospital, Riyadh, Saudi Arabia
| | - S K Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Melbourne, Australia
| | - M F A Quadri
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, USA.
- Department of Dental Public Health, Texas Tech University and Health Sciences Center, Texas, USA.
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Mathew MG, Jeevanandan G. 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. Cureus 2023; 15:e50327. [PMID: 38205476 PMCID: PMC10778429 DOI: 10.7759/cureus.50327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 01/12/2024] Open
Abstract
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.
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Affiliation(s)
- Mebin George Mathew
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Ganesh Jeevanandan
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Boachie MK, Molete M, Hofman K, Thsehla E. Cost-effectiveness of dental caries prevention strategies in South African schools. BMC Oral Health 2023; 23:814. [PMID: 37898738 PMCID: PMC10613394 DOI: 10.1186/s12903-023-03474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND In South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of children with dental caries remain untreated. To reduce this burden of disease, one key goal is to promote good oral health and address oral diseases through prevention, screening, and treatment among children. While all policies have been proven to be effective in the control and prevention of dental caries, it is unclear which of those strategies provide value for money. This study evaluated five caries preventative strategies in terms of the cost and benefits among South African school children. METHODS The study uses a hypothetical South African population of school aged learners aged 5-15. The context and insights of the strategies utilized at the schools were informed by data from both grey and published literature. Using Markov modeling techniques, we conducted a cost-effectiveness analysis of Acidulated Phosphate Fluoride (APF) application, atraumatic restorative treatment (ART), sugar-reduction and fissure sealants. Markov model was used to depict the movement of a hypothetical patient cohort between different health states over time. We assessed both health outcomes and costs of various interventions. The health outcome metric was measured as the number of Decayed, Missing, Filled Tooth (DMFT). The net monetary benefit was then used to determine which intervention was most cost-effective. RESULTS The results showed that school-based caries prevention strategies are cost-effective compared to the status quo of doing nothing. The average cost per learner over the 10-year period ranged from ZAR4380 to approx. ZAR7300 for the interventions considered. The total costs (including screening) associated with the interventions and health outcome (DMFT averted) were: sugar reduction (ZAR91,380, DFMT: 63,762), APF-Gel (ZAR54 million, DMFT: 42,010), tooth brushing (ZAR72.8 million, DMFT: 74,018), fissure sealant (ZAR44.63 million, DMFT: 100,024), and ART (ZAR45 million, DMFT: 144,035). The net monetary benefits achieved for APF-Gel, sugar reduction, tooth brushing, fissure sealant and ART programs were ZAR1.56, ZAR2.45, ZAR2.78, ZAR3.81, and ZAR5.55 billion, respectively. CONCLUSION Based on the net monetary benefit, ART, fissure sealant and sugar-reduction appear to be the most cost-effective strategies for preventing caries in South Africa. In a resource-scarce setting such as South Africa, where there is no fluoridation of drinking water, this analysis can inform decisions about service packages for oral health.
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Affiliation(s)
- Micheal Kofi Boachie
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, 4041, Durban, South Africa.
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa.
| | - Mpho Molete
- Department of Oral Biological Sciences, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Evelyn Thsehla
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
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Bağ İ, Çalışkan S, Erenel AO, Sevimli KN, Candan M. Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments? CHILDREN (BASEL, SWITZERLAND) 2023; 10:1705. [PMID: 37892368 PMCID: PMC10605608 DOI: 10.3390/children10101705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The utilization of evidence-based approaches is crucial to achieving long-term positive outcomes for treatment performed chairside or under general anesthesia. The study aimed to evaluate if treatment modality (at the chairside or under general anesthesia) affects prognosis and the need for re-treatment. METHODS Oral-hygiene, gingival, and plaque indexes were recorded during the control appointment. The success of all treatments was evaluated according to the scoring of particular evaluation criteria. RESULTS A total of 1066 dental procedures were performed on 92 children. Plaque index scores were higher for patients treated under general anesthesia. The success rate of restorative procedures was 82.5% under general anesthesia and 80.6% at the chairside. There was no statistically significant difference between the mean number of restorative treatments and the need for re-treatment between general anesthesia or chairside (p = 0.649, p = 0.311). The mean number of unsuccessful endodontic treatments performed under general anesthesia was higher than performed chairside. Only two out of thirty stainless-steel crowns were decemented, all performed under general anesthesia. CONCLUSIONS The high volume of restoration failure due to secondary caries has highlighted the need for alternative approaches to caries management, especially given the risks associated with repeat general anesthetic.
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Affiliation(s)
- İrem Bağ
- Department of Pediatric Dentistry, Faculty of Dentistry, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey; (S.Ç.); (A.O.E.); (K.N.S.); (M.C.)
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Mathew MG, Jeevanandan G. Perceived Outcomes, Parental Satisfaction, and Oral Health-Related Quality of Life After Full Mouth Rehabilitation Under General Anesthesia for Early Childhood Caries. Cureus 2023; 15:e47126. [PMID: 38022373 PMCID: PMC10648478 DOI: 10.7759/cureus.47126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
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.
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Affiliation(s)
- Mebin George Mathew
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Chennai, IND
| | - Ganesh Jeevanandan
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Chennai, IND
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Faheem M, Moheb D, Bahgat S, Splieth C, Bekes K. Changes in Oral-Health-Related Quality of Life of Egyptian Children Treated under Dental General Anesthesia: A Prospective Study. J Clin Med 2023; 12:5792. [PMID: 37762733 PMCID: PMC10532267 DOI: 10.3390/jcm12185792] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Treatment of young children under dental general anesthesia (DGA) is sometimes necessary due to lack of cooperation and the complexity of dental treatment. The aim of this study was to assess the changes in oral-health-related quality of life (OHRQoL) in children following treatment under DGA. METHODS A consecutive sample of 88 children aged 5 and younger who were referred to the department of pediatric dentistry, Cairo university, Egypt, for treatment under DGA was included. Parents were asked to complete the Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) questionnaire before and 4 weeks after treatment. The Wilcoxon signed-rank test was used to compare baseline and follow up scores. Effect sizes (ES) were also calculated. RESULTS The overall ECOHIS scores decreased significantly from 16.72 (±7.07) to 0.9 (±3.08); (p < 0.001, Wilcoxon signed-rank test) after treatment under DGA, demonstrating a large effect size of 2.2. The scores of the two subscales of the ECOHIS, the child impact scale (CIS) and the family impact scale (FIS), also decreased significantly (p < 0.001). CONCLUSIONS Treatment under DGA not only improved the OHRQoL of the Egyptian children in our sample significantly, but also had a positive effect on their families' quality of life.
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Affiliation(s)
- Mahmoud Faheem
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17489 Greifswald, Germany; (M.F.); (C.S.)
| | - Dalia Moheb
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Cairo 12613, Egypt; (D.M.)
- School of Dentistry, Newgiza University, Giza 12577, Egypt
| | - Sherif Bahgat
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Cairo 12613, Egypt; (D.M.)
| | - Christian Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17489 Greifswald, Germany; (M.F.); (C.S.)
| | - Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
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Mathew MG, Jeevanandan G, Vishwanathaiah S, Khubrani YM, Depsh MA, Almalki FY. Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries. J Contemp Dent Pract 2023; 24:250-256. [PMID: 37469264 DOI: 10.5005/jp-journals-10024-3500] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
AIM To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries. MATERIALS AND METHODS About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up. RESULTS All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment. CONCLUSION Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries. CLINICAL SIGNIFICANCE Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.
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Affiliation(s)
- Mebin George Mathew
- Department of Pediatric and Preventive dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India, Phone: +91 9884293869, e-mail:
| | - Satish Vishwanathaiah
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia, Phone: +966542635434, e-mail:
| | | | - Masood Ahmed Depsh
- Dental Intern, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Linas N, Peyron MA, Cousson PY, Decerle N, Hennequin M, Eschevins C, Nicolas E, Collado V. Comprehensive Dental Treatment under General Anesthesia Improves Mastication Capability in Children with Early Childhood Caries-A One-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:677. [PMID: 36612993 PMCID: PMC9819280 DOI: 10.3390/ijerph20010677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Using the granulometry of ready-to-swallow food boluses, this study investigated the evolution of masticatory capability of children with Early Childhood Caries (ECC) after comprehensive dental treatment under general anesthesia (GA). METHODS Sixteen children with ECC were assessed before and over one year after dental treatment under GA, in comparison with 12 children with a Healthy Oral State (HOS). Oral health criteria, quality of life, body mass index, and frequency of orofacial dysfunctions were recorded. Masticatory kinematic parameters and median food bolus particle size (D50) at swallowing were assessed while masticating raw carrot (CAR), cheese (CHS), and breakfast cereals (CER). The impact of posterior teeth extractions was analyzed. RESULTS Quality of life and orofacial functions improved after dental treatment. Chewing frequency for all three foods increased without reaching the values of children with HOS, while D50 values for CAR and CHS decreased. After one year, children with posterior teeth extractions exhibited higher D50 values for CAR and CHS than children with only conservative treatment. One third of children with ECC were overweight or obese. CONCLUSIONS Comprehensive dental treatment improved children's mastication, and their BMI subsequently increased. Links between mastication and nutrition should be investigated further in children.
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Affiliation(s)
- Natacha Linas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Marie-Agnès Peyron
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- CRNH Auvergne, Human Nutrition Unit (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Pierre-Yves Cousson
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Nicolas Decerle
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Caroline Eschevins
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Valérie Collado
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
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11
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Ehlers V, Callaway A, Patyna M, Pelkner A, Azrak B, Deschner J. Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia. J Clin Med 2022; 11:jcm11133676. [PMID: 35806961 PMCID: PMC9267542 DOI: 10.3390/jcm11133676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/16/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: The aim of this study was to assess oral health in children following dental treatment under general anaesthesia and to obtain information about oral health measures in both the children and their parents. (2) Methods: Children were scheduled for regular dental re-examination one to six years after dental treatment under general anaesthesia. Scores for mixed dmft/DMFT, the plaque control record (PCR), and the gingival bleeding index (GBI) were determined. Information about children’s/parents’ oral hygiene habits and frequency of dental visits was obtained. Scores for mixed dmft/DMFT as assessed before dental treatment under general anaesthesia/at re-examination were compared (Wilcoxon test). (3) Results: From the 134 parents initially contacted, 35 attended regular dental control visits (response rate: 26%) with their children (median age 6 years). Of the 35 children (20 female, 15 male), 18 (51.4%) were healthy and 17 (48.6%) had a pre-existing condition. Mixed dmft/DMFT scores determined at the recall visit differed significantly from the earlier visit (p = 0.006). Children had 1.74 ± 3.64 teeth newly affected by caries. Four children (11.4%) needed dental treatment under general anaesthesia again. Oral hygiene was mediocre (median PCR: 32%). The GBI was high (median: 14%). Children with a high PCR also had a high GBI. (4) Conclusions: Children who had received dental treatment under general anaesthesia still had a high caries risk. Further prophylaxis programs are necessary to prevent caries and further use of general anaesthesia.
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12
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Zhao J, Yang L, Lai G, Wang J. Clinical outcomes of dental treatment under general anesthesia and its effects on the caries activity and body growth of children: a 2-year retrospective study. Clin Oral Investig 2022; 26:4091-4098. [PMID: 35118521 DOI: 10.1007/s00784-022-04377-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To analyze clinical outcomes of dental treatment under general anesthesia (DGA) and its effects on children's caries activity status and body growth within 2 years after the treatment. MATERIALS AND METHODS The case data and 2-year follow-up records of children who underwent DGA from February 2017 to February 2018 were collected and analyzed. The general characteristics of the sample, the success rates of treatment procedures, the caries recurrence rate, the caries activity test scores, and the BMI of all the children were described. The caries activity levels between children with and without caries recurrence at 24 months after DGA were compared before and after DGA to explore the relationship between caries activity level and caries recurrence. The correlation between BMI level and caries recurrence was explored using Cox regression analysis. RESULTS A total of 94 children consisting of 46 boys and 48 girls were included in this study. The average dmft score before DGA was 13.90. Within 2 years after the treatment, composite fillings and strip crowns of the anterior teeth achieved similar success rates, around 90%; SSCs showed a similar success rate to composite fillings of posterior teeth (P = 1.000); the clinical success rate of pulpectomy was 90.43%. All the children showed no caries relapse at 1 month after DGA. The number of children with caries relapse at 6-, 12-, and 24-month post-treatment was 24 (25.53%), 35 (37.23%), and 53 (56.38%), respectively. The caries activity scores at each follow-up were significantly lower than those before the treatment (P < 0.0001). Children with caries relapse within 2 years after DGA showed no significantly different caries activity scores than children without caries relapse before and after the treatment. The proportion of children with normal BMI at 12 months after DGA was significantly higher than that before DGA (P = 0.007), and the difference was still very significant at 24 months after DGA (P < 0.0001). Statistical results showed a correlation between BMI level before DGA and caries recurrence (P < 0.001). CONCLUSIONS Dental treatment under general anesthesia achieves acceptable clinical outcomes in this study. Children's caries activity scores decrease significantly. Low or high BMI levels before DGA drift towards normal after the treatment. CLINICAL RELEVANCE Acceptable outcomes are achieved within 2 years after dental treatment under general anesthesia. However, children with abnormal BMI before the treatment tend to have caries relapse.
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Affiliation(s)
- Jin Zhao
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, No. 500 Quxi Road, Huangpu District, Shanghai, China
| | - Lianyi Yang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, No. 500 Quxi Road, Huangpu District, Shanghai, China
| | - Guangyun Lai
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, No. 500 Quxi Road, Huangpu District, Shanghai, China.
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, No. 500 Quxi Road, Huangpu District, Shanghai, China.
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13
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Hasslöf P, Granqvist L, Stecksén-Blicks C, Twetman S. Prevention of Recurrent Childhood Caries with Probiotic Supplements: A Randomized Controlled Trial with a 12-Month Follow-Up. Probiotics Antimicrob Proteins 2022; 14:384-390. [PMID: 35083729 PMCID: PMC8791080 DOI: 10.1007/s12602-022-09913-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the effect of drops containing probiotic bacteria on the recurrence of dental caries in preschool children. The study employed a randomized, placebo-controlled, double-blinded design with two parallel arms. 38 preschool children were enrolled after comprehensive restorative treatment under general anesthesia or conscious sedation (baseline), and they were followed up after 6 and 12 months. Parents of children in the test group were instructed to give 5 daily drops containing two strains of Limosilactobacillus reuteri (DSM 17938 and ATCC PTA 5289) at bedtime. The placebo drops were identically composed but lacked bacteria. The duration of the intervention was 12 months. The primary endpoint was recurrence of new caries lesions on subject level (yes/no), and secondary endpoints were presence of dental plaque and gingivitis. We found high rate of recurrent moderate and extensive lesions after 12 months (67%) but there were no significant differences between the groups. We observed no beneficial effects on dental plaque or gingival inflammation. The findings were however uncertain and inconclusive due to lack of power, a consequence of the COVID-19 pandemic. ClinTrials.gov Identifier: (NCT04929340), June 18, 2021; retrospectively registered.
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Affiliation(s)
- P Hasslöf
- Department of Odontology, Pediatric Dentistry, Faculty of Medicine, Umeå University, 90187, Umeå, Sweden.
| | - L Granqvist
- Pediatric Dentistry, Eastman Dental Institute, Stockholm, Sweden
| | - C Stecksén-Blicks
- Department of Odontology, Pediatric Dentistry, Faculty of Medicine, Umeå University, 90187, Umeå, Sweden
| | - S Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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14
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Randall CL, Wallace E, Heaton LJ, Christiansen M, Kim A, Seminario AL, McKinney CM. Longitudinal Analysis of Children's Oral Health-Related Quality of Life After Restorative Dental Treatment. Pediatr Dent 2021; 43:223-229. [PMID: 34172117 PMCID: PMC8244533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: To document mid- and long-term changes in oral health-related quality of life (OHRQoL) following dental intervention in a sample of restorative treatment-naïve children receiving different levels of care, with and without general anesthesia (GA). Methods: This prospective cohort study followed 132 children. Parents completed the pediatric OHRQoL instrument (POQL) before, 16 weeks after (i.e., posttreatment), and 18 to 45 (mean equals 29.5) months after (i.e., follow-up) child receipt of treatment. Parents provided child demographic and oral health information. The number of restored surfaces and anesthesia type were abstracted from dental records. The mean differences in POQL scores were compared across groups. Results: The sample was 49 percent female (age range equals four to 12 years; mean±standard deviation equals 5.8±1.8). Overall, from pretreatment to posttreatment, mean POQL scores decreased by 4.5 points (P<0.001), representing improved OHRQoL. Only among children with 10 or more surfaces restored or who received GA did follow-up POQL scores remain significantly lower than pretreatment scores (mean difference equals -7.4 and -8.0, respectively, P<0.01). Overall, follow-up scores were significantly higher than posttreatment scores, representing a decline from the initial improvement. Conclusions: Regardless of disease severity, children experience an immediate improvement in OHRQoL following restorative treatment. Improvements in OHRQoL are sustained over the long-term only among children with more extensive pretreatment needs.
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Affiliation(s)
- Cameron L Randall
- Dr. Randall is an acting assistant professor, Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Wash., USA;,
| | - Erin Wallace
- Dr. Wallace is a clinical research scientist, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, University of Washington, Seattle, Wash., USA
| | - Lisa J Heaton
- Dr. Heaton is an assistant professor, Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Wash., USA
| | - Matthew Christiansen
- Mr. Christiansen is a clinical research coordinator, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, University of Washington, Seattle, Wash., USA
| | - Amy Kim
- Dr. Kim is an associate director, Advanced Education in General Dentistry Program, at the NYU Langone Health Dental Medicine-Family Health Centers, Brooklyn, N.Y. USA
| | - Ana Lucia Seminario
- Dr. Seminario is an associate professor, Department of Pediatric Dentistry, School of Dentistry, and adjunct associate professor, Department of Global Health, School of Public Health, University of Washington, Seattle, Wash., USA
| | - Christy M McKinney
- Dr. McKinney is an associate professor, Division of Craniofacial Medicine, Department of Pediatrics, School of Medicine, University of Washington, and principal investigator, Seattle Children's Research Institute, Seattle, Wash., USA;,
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15
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Factors Influencing the Survival of Preformed Zirconia Crowns in Children Treated under General Anesthesia. Int J Dent 2021; 2021:5515383. [PMID: 33833801 PMCID: PMC8012123 DOI: 10.1155/2021/5515383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/18/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022] Open
Abstract
Aim This study aimed to retrospectively evaluate the success of zirconia crowns placed in the anterior teeth of children and evaluate the impact of pulp therapy of the tooth on the rate of failure. Materials and Methods A total of 70 anterior teeth of 20 children aged between 3 and 5 years who had undergone the placement of zirconia crowns under general anesthesia were followed up for 24 months. Kaplan-Meier Survival curves were plotted for the estimation of two-year survival time. The outcomes for teeth that had received pulp therapy were compared to those that had not received pulp therapy. Results Kaplan-Meier survival analysis of 70 crowns observed over a two-year period showed that mean survival time for the crowns was 38.7 months with a confidence interval ranging from 38.1 months to 39.3 months. When the survival of the crowns was observed based on the presence or absence of symptoms, it was observed that only 4 out of the 70 crowns were symptomatic (with or without crown loss) at the end of two years, giving a success rate of 94.3%. The mean survival time was also increased to 39.5 months (confidence interval 39.15-39.98 months). Conclusion Zirconia crowns provide an acceptable level of success and longevity. Crowns placed on teeth after pulp therapy are more likely to fail than those placed on teeth without pulp therapy.
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16
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Comparison of Survival Rates of Stainless-Steel Crowns Placed with and without Pulpotomy: A Two-Year Retrospective Study. Int J Dent 2020; 2020:8883189. [PMID: 33144859 PMCID: PMC7599394 DOI: 10.1155/2020/8883189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 01/17/2023] Open
Abstract
Aim. This study aimed to retrospectively compare the survival outcomes over two years between teeth with proximal dental caries that were restored with stainless-steel crowns to those that were pulpotomized and then restored with a stainless-steel crown in patients who were rehabilitated under general anesthesia. Participants and Methods. The records of 131 patients aged between two to six years who had stainless-steel crowns placed under general anesthesia and had two-year follow-up were screened. 340 teeth with moderate proximal caries on the radiograph (D2) were included in the study. Of these, 164 teeth were treated with a pulpotomy and stainless-steel crown, while 176 teeth were crowned without a pulpotomy. The type of each tooth was compared using the Chi-squared test and Kaplan–Meier survival analysis, and curves were plotted based on the two-year outcomes. Results. Treatment: the sample comprised 59 males (mean age 4.73 years, SD ± 1.4 years) and 72 females (mean age 5.2 years, SD ± 2.0 years). The Kaplan–Meier regression model showed no significant difference in survival outcomes between teeth that had been pulpotomized and those that had not (
= 0.283). Conclusion. Within the limitations of the current study, we can conclude that performing a pulpotomy does not influence the survival outcome of mild/moderate proximal caries restored with stainless-steel crowns under general anesthesia.
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Oubenyahya H, Bouhabba N. General anesthesia in the management of early childhood caries: an overview. J Dent Anesth Pain Med 2019; 19:313-322. [PMID: 31942447 PMCID: PMC6946837 DOI: 10.17245/jdapm.2019.19.6.313] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/13/2019] [Accepted: 10/30/2019] [Indexed: 11/22/2022] Open
Abstract
Early childhood caries is a global healthcare concern in developing and industrialized countries. If left untreated, it leads to immediate and long-term complications that affect the well-being and quality of life of concerned families. Therefore, many preventive and treatment approaches are available to the healthcare provider to curb this virulent form of caries. After behavioral interventions, general anesthesia is used in specific settings when a young patient presents with extensive teeth damage and exhibits a lack of cooperation that is incompatible with conventional dental office care. However, without proper follow-up, any positive results might be lost over time.
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Affiliation(s)
- Hanan Oubenyahya
- Department of Dentistry, Military Hospital Agadir, Agadir, Morocco
| | - Najib Bouhabba
- Department of Anesthesiology, Military Hospital Agadir, Agadir, Morocco
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