The impact of general medical health status, demographical, and patient-specific variables on need for dental treatment of children and adolescents under general anesthesia

Kries, Tilman; Rupf, Stefan; Hannig, Matthias; Naim, Jusef; Gund, Madline P.

doi:10.1007/s00784-023-05041-y

Cited by 6 publications

(2 citation statements)

References 47 publications

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“…Most of the patients who were treated in the study were young and healthy, which is similar to previous studies [36,37]. Our study did not consider pediatric patient age or medical condition as signi cant predictors for OT among different resident levels.…”

Section: Discussionsupporting

confidence: 83%

The Residency Levels Effect on Pediatric Dental Rehabilitation Operation Time

Baakdah,

Al-Hinidi,

Al-Sharif

et al. 2023

Preprint

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Background General anesthesia (GA) is the most frequently used pharmacological intervention in pediatric dental care. Postgraduate pediatric dental residents must perform a variety of pediatric dental rehabilitation procedures under GA at different levels of training. An adequate operation time (OT) decreases morbidity risk and improves hospital time utilization efficiency. The aim of the study is to assess the effect of pediatric dental resident training level on OT for pediatric dental rehabilitation procedures under GA. Methods A cross-sectional study of data from all pediatric dental rehabilitation procedures that were performed under GA by pediatric dental residents at KAMC-Jeddah from 2015 to 2022 was conducted. The primary outcome was OT, and the predictive variable was resident training levels. A linear regression analysis was used to compare OT between procedures performed by junior (years 1–2) or senior (years 3–4) trainees, adjusting for patient and operative factors. Results A total of 1007 pediatric dental rehabilitation cases were performed under GA by junior (25%) and senior (65%) residents. The univariant analysis indicated that senior residents had significantly longer OTs (13 minutes) than junior residents. However, after considering significant variables, the linear regression analysis showed that senior residents had a significantly shorter OT and performed significantly more dental procedures than junior residents. Senior residents took significantly more radiographs and performed significantly more primary pulp therapies and multisurface anterior colored restorations under GA than junior residents. Conclusions The OT for pediatric dental rehabilitation procedures under GA is associated with resident training level. The total operation time was significantly longer based on procedure number, type, and resident level. This finding highlights the importance of assigning procedures that require GA to residents based on their level and the complexity of the case. Additionally, it evaluates residents’ competency development and assesses the impact of residency training programs on hospital efficiency. Trial registration: The KAIMRC Internal Review Board (IRB/1514/22) registered this cross-sectional chart review.

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Section: Discussionsupporting

confidence: 83%

The Residency Levels Effect on Pediatric Dental Rehabilitation Operation Time

Baakdah,

Al-Hinidi,

Al-Sharif

et al. 2023

Preprint

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“…Lastly, the study population comprised only children referred to our pediatric department following management failure, thus representing a specialized group with specific needs. Nevertheless, our population closely mirrors those in other studies on pediatric dentistry under general anesthesia, with an average age of 4.9, as compared to 4.7 [ 46 , 47 ]. These characteristics precisely reflect the population where the decision to use general anesthesia is debatable, making them the ideal population to evaluate the SCAN-score.…”

Section: Discussionsupporting

confidence: 80%

Development and Validation of the SCAN-Score to Indicate General Anesthesia for Dental Care in Children

Berat,

Jacq,

Villain

et al. 2024

JCM

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Background: General anesthesia is an approach used to address behavior issues in pediatric dentistry. This indication often relies on the practitioner’s discretion rather than objective criteria. We developed SCAN-score to assist pediatric dentists in the case of doubt to indicate general anesthesia for uncooperative children. The study aims were to assess the validity of the SCAN-score, which aims to indicate general anesthesia or chairside management for dental care. Methods: A retrospective study was performed on children aged between 2 and 10 years who received dental care. The SCAN-score combined three item scales (age, need of care, behavior) and three additional factors: communication barriers, permanent teeth caries, and local anesthesia contraindications. Mean scores were estimated. An ROC curve was constructed with sensitivities and specificities obtained. Results: The study included 284 children, with 154 treated through chairside methods and 130 treated under general anesthesia. The mean score was 5.6 ± 2.8 in the chairside management group and 12.9 ± 1.9 in the general anesthesia group. The sensitivity of the score (cutoff at 10) was 0.99, and the specificity was 0.94. The estimate of the ROC is 0.994. Conclusions: The SCAN-score appears to be an excellent tool to support the practitioner’s decision to refer to general anesthesia care.

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Dental treatment of children with special healthcare needs: A retrospective study of 10 years of treatment

Hieronymus,

Aydin,

Frese

et al. 2024

Int J Paed Dentistry

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Background/AimChildren with special healthcare needs (CSHCN) often face oral health challenges. This retrospective cross‐sectional study at a university hospital aimed to determine CSHCN's medical spectrum, dental treatment needs, and mode of treatment: general anesthesia (GA) or outpatient dental care (ODC).DesignData from the Department of Conservative Dentistry, Heidelberg University Hospital, 2012–2022, were reviewed, considering age, gender, International Classification of Diseases‐10 diagnoses, caries experience (dmft/DMFT), restorative parameters, and treatment under GA/ODC. For patients under GA, their American Society of Anesthesiologists (ASA) classification was considered. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney U‐test and logistic regression were utilized.ResultsOf 669 patients, congenital and chromosomal malformations (34.7%), diseases of the nervous system (19.1%), and mental and behavioral disorders (16.0%) were mainly diagnosed. Dentin caries prevalence was high at 79.1%, with treatments performed mainly under GA (51.4%). The odds of receiving treatment under GA decreased with patient age and increased with higher dmft/DMFT scores. Most under GA were classified as ASA 3 (51.7%), indicating high anesthesia risks.ConclusionChildren with special healthcare needs often have diseases that can lead to higher challenges related to cooperation. The high prevalence of dentin caries underscores the substantial need for dental treatments, which were consequently often performed under GA, despite the associated risks. These findings stress the need for trained dental professionals.

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The impact of general medical health status, demographical, and patient-specific variables on need for dental treatment of children and adolescents under general anesthesia

Cited by 6 publications

References 47 publications

The Residency Levels Effect on Pediatric Dental Rehabilitation Operation Time

The Residency Levels Effect on Pediatric Dental Rehabilitation Operation Time

Development and Validation of the SCAN-Score to Indicate General Anesthesia for Dental Care in Children

Dental treatment of children with special healthcare needs: A retrospective study of 10 years of treatment

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