Region Jnkpings ln Odontologiska Institutionen
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Dental treatment of children under general anaesthesia in hospital day-stay units – a 20-year retrospective study

Norderyd J*, Dyster-Aas A, Hallonsten A-L
 

Background

In Sweden all children receive dental treatment up to 19 years of age, including specialist dental care and dental treatment under general anaesthesia (GA) free of charge through the Public Dental Service. All treatment is based on the United Nation's Convention on the Rights of the Child. Physical restraints, including the hand-over-mouth-technique, are forbidden.

Aim

The aims of the study were to estimate the need for dental treatment under GA in a Swedish child population and to evaluate the following: changes in indications for dental treatment under GA, age at treatment, and dental treatment performed during a 20-year period.

Materials and methods

Dental treatment under GA in Jönköping County, Sweden, has been separately studied during three different 4-year periods, 1983–1986, 1991–1994, and 2000–2003. During these years, 1,693 children 0–19 years of age had dental treatment under GA. Three dental records were missing and 152 anaesthesia records were not available. Thus data from 1,690 dental records and 1,541 anaesthesia records were collected. 

Results

The number of children treated under GA increased from the first time period to a prevalence of 0.2 % in the two latter periods. Age distribution shifted towards older children. Disability was the most common reason for deciding to perform dental treatment under GA in 1983–1986 (33.5 %). In 1991–1994, behaviour management problems was the main reason (36 %). In 2000–2003 behaviour management problems (36 %) together with disability (32 %) dominated. The percentage of children who needed dental treatment under GA because of caries was 82 %, 87 %, and 68 % in the three time periods, respectively. When classified according to the Health Classification of the American Society of Anaesthesiologists (ASA), the main part of the children were healthy. Only 0.4 %, 2 %, and 5 % children during the three periods, respectively, belonged in ASA group III. No patients were diagnosed in ASA IV or V. Vomiting postoperatively was the most common side-effect, and no life-threatening complications occurred during the years studied.

Conclusions

The need for dental treatment under GA is estimated to be 2–3 per 1000 children in a region with a well-organised Public Dental Service that offers specialist dental care.

  • Complications in relation to GA have been minor.
  • To be able to provide optimal dental care to all children, the Public Dental Service must be able to offer dental treatment under GA when necessary.
Uppdaterad: 2013-04-03
Anna Thofelt, Avdelningen för odontologisk radiologi Jönköping, Folktandvården