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Is dental general anaesthesia in children an outdated concept? A retrospective analysis
Pubblication date: 31/2020
Authors: D. Schnabl1, L. L. Schanner1, F. Barbieri2, J. Laimer1, E. Bruckmoser3, R. Steiner1, I. Grunert1
Institution: ¹Department of Operative and Prosthetic Dentistry, Medical University of Innsbruck, Innsbruck, Austria
²Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
³Private Practice for Oral and Maxillofacial Surgery, Salzburg, Austria
Publication: European Journal of Paediatric Dentistry
Publisher: Ariesdue Srl
Keywords: Dental general anaesthesia; Caries prevalence; Childhood caries; Special needs; Ethnicity.
Title: Is dental general anaesthesia in children an outdated concept? A retrospective analysis
Abstract: Aim The aim of this retrospective study was to determine the prevalence of caries and treatment needs in the collective of patients ≤16 years of age, who underwent scheduled dental general anaesthesia (DGA) at the University Clinic of Innsbruck from January 2015 to June 2019, with respect to demographic factors.
Materials and methods A retrospective analysis of children’s diagnoses, demographics, and dental treatment under general anaesthesia in Innsbruck, Austria, from 2015 to 2019 was performed. Anonymised demographic data (age; gender; the presence or absence of general disease or disablement; parents’ first language (German- (GS) or non-German-speaking (non-GS), reflecting ethnicity; and the number of teeth restored and extracted under DGA were collected from patients’ files. Data was analysed by means of descriptive and comparative statistics.
Results The main group consisted of 545 subjects at a median age of 5.3 (IQR 4.4-6.6) years, who had exclusively primary teeth and or first molars that received restorations or were extracted. Of the subjects, 84.4% were classified with uncooperativeness due to dental anxiety and 15.6% with systemic diseases or intellectual and or physical disablement. In this group, 47.9% were GS and 52.1% were non-GS or had GS or non-GS parents. In the total sample, 5 (IQR 3-7) primary teeth were restored and 4 (IQR 4-7) extracted. Subgroup analysis revealed statistically significant differences in the number of extracted primary teeth between children with and without systemic diseases or disablement - 3 (IQR 1-5) versus 4 (IQR 2-7) - and between children of GS and non-GS parents - 4 (IQR 2-6) versus 5 (IQR 3-7.8). Zero (IQR 0-0) first molars were filled and extracted.
Conclusions Within the study collective of children in poor oral health, the offspring of non-GS families were overrepresented (compared to their prevalence in the total population) and displayed a higher prevalence of deep caries than those of GS parents. By intensifying and special gearing of prophylactic measures to the non-GS population and promoting the parents’ insight into the importance of oral hygiene and regular dental attendance, the demand for scheduled DGA might be greatly reduced. In the small share of children who suffer from severe diseases or disablement and are thus unable to cooperate with home care or dental treatment, DGA will remain the treatment of choice.