SAĞLIKLI ÇOCUKLAR İLE ÖZEL SAĞLIK GEREKSİNİMİ OLAN ÇOCUKLARDA GENEL ANESTEZİ ALTINDA DİŞ TEDAVİSİNİN ÖZELLİKLERİ VE KARŞILAŞTIRILMASI: RETROSPEKTİF BİR ÇALIŞMA

Abstract

Çalışmamızda Erciyes Üniversitesi Diş Hekimliği Fakültesi’nde sağlıklı ve özel sağlık gereksinimi (ÖSG) olan çocuklarda genel anestezi altında yapılan diş tedavilerinin karşılaştırılması ve değerlendirilmesi amaçlanmıştır. Çalışmaya Ocak 2021 - Eylül 2022 tarihleri arasında genel anestezi altında diş tedavisi yapılan 1-14 yaş arasında toplamda 1461 çocuğun kayıtlarından elde edilen verilen dahil edilmiştir. Çalışma grupları sağlıklı ve ÖSG olan çocuklar şeklinde belirlenmiştir. Hastaların yaşı ve cinsiyeti, tedavi edilen diş sayısı ve yapılan tedaviler (çekim, kanal tedavisi, kompozit/kompomer restorasyon vb. gibi) sağlıklı ve ÖSG grupları için ayrı ayrı kaydedilmiştir. Veri analizleri için tanımlayıcı istatistiksel analizler, Ki Kare ve Mann-Whitney U Testi testleri kullanılmıştır. p<0.05 anlamlılık düzeyi kabul edilmiştir. Çalışmaya dahil edilen çocukların %75.4’ü sağlıklı; %24.5’i ÖSG grubu oluşturmaktadır. ÖSG olan çocukların yaş ortalaması 8.31 iken sağlıklı çocukların yaş ortalaması 6.37’dir. Altı yaş üstü ÖSG olan çocuklarda DMFT skoru, aynı yaş grubunda sağlıklı olan çocuklara göre istatistiksel olarak anlamlı derecede yüksek bulunmuştur (p<0.001). ÖSG olan çocukların %58.6’sında tekrarlayan genel anestezi ile diş tedavisine ihtiyaç duyulmuştur. ÖSG olan çocuklarda çekim gibi radikal tedavi yaklaşımlarının kullanımı ve tekrarlayan genel anestezi/sedasyon ihtiyacında artış gözlemlenmiştir. ÖSG olan çocuklarda ağız sağlığı eğitimine ve önleyici stratejilere daha fazla önem verilmesi gerekmektedir.

Keywords

• Diş tedavisi
• genel anestezi
• özel sağlık gereksinimli çocuklar

CHARACTERISTICS AND COMPARISON OF DENTAL TREATMENT UNDER GENERAL ANESTHESIA IN HEALTHY CHILDREN AND CHILDREN WITH SPECIAL HEALTH NEEDS: A RETROSPECTIVE STUDY

Abstract

The aim of this retrospective study was to assess and compare the dental treatments performed under general anesthesia between healthy children and children with special health care needs (SHCN) in Erciyes University Faculty of Dentistry. The data obtained from the records of 1461 children aged 1-14 years who underwent dental treatment under general anesthesia between January 2021 and September 2022 were included in the study. The study groups were determined as healthy children and children with SCHN. The age and gender of patients, number of teeth treated, treatments performed (extraction, root canal treatment, composite/compomer restoration, etc.) were recorded separately for healthy children and children with SCHN. Descriptive statistical analyzes, Chi-Square and Mann-Whitney U Tests were used for data analysis. An efficacy level of p<0.05 was accepted. 75.4% of the children included in the study were healthy children; 24.5% of them were children with SCHN. While the average age of children with SCHN were 8.31, the average age of healthy children is 6.37. The DMFT score was found to be statistically significantly higher in children over 6 years of age with SCHN than in healthy children in the same age group (p<0.001). Recurrent dental treatment with was required in 58.6% of children with SCHN. The use of radical treatment approaches such as extraction and the need for recurrent general anesthesia/sedation have increased in children with SCHN. Oral health education and preventive strategies should be given more importance in children with SCHN.

Keywords

• Dental Treatment
• general anesthesia
• children with special health care needs

References

1. Mallineni SK, Yiu CK. Dental treatment under general anesthesia for special‐needs patients: analysis of the literature. J Investig Clin Dent. 2016;7(4):325-31. doi: 10.1111/jicd.12174. PMID: 26202903.
2. Guideline on management of dental patients with special health care needs. Pediatr Dent. 2012;34(5):160-5. PMID: 23211903.
3. Lewis CW. Dental care and children with special health care needs: a population-based perspective. Acad Pediatr. 2009;9(6):420-6. doi:10.1016/j.acap.2009.09.005. PMID: 19945077.
4. Lewis C, Robertson AS, Phelps S. Unmet dental care needs among children with special health care needs: implications for the medical home. Pediatrics. 2005;116(3):426-31. doi: 10.1542/peds.2005-0390. PMID: 16140688.
5. Mayer ML, Cockrell Skinner A, Slifkin RT. Unmet need for routine and specialty care: data from the National Survey of Children With Special Health Care Needs. Pediatrics. 2004;113(2):109-15. doi: 10.1542/peds.113.2.e109. PMID: 14754979
6. Nelson LP, Getzin A, Graham D, et al. Unmet dental needs and barriers to care for children with significant special health care needs. Pediatr Dent. 2011;33(1):29-36. PMID: 21406145
7. Purohit BM, Acharya S, Bhat M. Oral health status and treatment needs of children attending special schools in South India: a comparative study. Spec Care Dentist. 2010;30(6):235-41. doi: 10.1111/j.1754-4505.2010.00160.x.
8. Nahar SG, Hossain MA, Howlader MB, Ahmed A. Oral health status of disabled children. Bangladesh Med Res Counc Bull. 2010;36(2):61-3. PMID: 21473203.

9. Oredugba FA. Use of oral health care services and oral findings in children with special needs in Lagos, Nigeria. Spec Care Dentist. 2006;26(2):59-65. doi: 10.1111/j.1754-4505.2006.tb01511.x. PMID: 16681240.
10. Guideline on Behavior Guidance for the Pediatric Dental Patient. Pediatr Dent. 2015;37(5):57-70. PMID: 26531077.
11. American Academy of Pediatric Dentistry. Cariesrisk assessment and management for infant, children, and adolescents. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2020:243-7.
12. Blayney M, Malins A, Cooper G. Cardiac arrhythmias in children during outpatient general anaesthesia for dentistry: a prospective randomised trial. Lancet. 1999;354(9193):1864-6. doi: 10.1016/s0140-6736(99)02485-x. PMID: 10584723.
13. Bohaty B, Spencer P. Trends in dental treatment rendered under general anesthesia, 1978 to 1990. J Clin Pediatr Dent. 1992;16(3):222-4. PMID: 1388052.
14. Jamieson LM, Roberts-Thomson KF. Dental general anaesthetic trends among Australian children. BMC Oral Health. 2006;6(1):1-7. doi: 10.1186/1472-6831-6-16. PMID: 17184552.
15. Park MS, Sigal MJ. The role of hospital-based dentistry in providing treatment for persons with developmental delay. J Can Dent Assoc. 2008;74(4). PMID: 18538073.
16. Al-Ogayyel S, Ali SA-H. Comparison of dental treatment performed under general anesthesia between healthy children and children with special health care needs in a hospital setting, Saudi Arabia. J Clin Exp Dent. 2018;10(10):963-69. doi: 10.4317/jced.55060. PMID: 30386501.
17. Cantekin K, Doğan S, Aydınbelge M, et al. Analysis of comprehensive dental rehabilitation under general anesthesia at a dental hospital in Turkey. J Pediatr Dent. 2014; 2(2):49-55. doi: 10.4103/2321-6646.137678.
18. Sevekar S, Jha MN, Avanti A. Characteristics and comparison of dental treatment under general anesthesia in healthy children and children with special healthcare needs: a retrospective study. Int J Clin Pediatr Dent. 2021;14(2):157-161. doi: 10.5005/jp-journals-10005-2098.
19. Chen C-Y, Chen Y-W, Tsai T-P, Shih W-Y. Oral health status of children with special health care needs receiving dental treatment under general anesthesia at the dental clinic of Taipei Veterans General Hospital in Taiwan. J Chin Med Assoc. 2014;77(4):198-202. doi: 10.1016/j.jcma.2014.01.008. PMID: 24602501.
20. Chia-Ling Tsai B, Yi-Ling Tsai B, Yng-Tzer Lin B, Yai-Tin Lin B. A retrospective study of dental treatment under general anesthesia of children with or without a chronic illness and/or a disability. Chang Gung Med J. 2006;29(4):412-8. PMID: 17051840.
21. Ibricevic H, Al-Jame Q, Honkala S. Pediatric dental procedures under general anesthesia at the Amiri Hospital in Kuwait. J Clin Pediatr Dent. 2001;25(4):337-42. doi: 10.17796/jcpd.25.4.fl062x558qtt4v69 PMID: 11497018.
22. Baygin O, Tuzuner T, Kusgoz A, et al. Effects of medical and mental status on treatment modalities in patients treated under general anaesthesia at the KTU Faculty of Dentistry in Trabzon, Turkey: A comparative retrospective study. J Pac Med Assoc. 2017;67(2):305-7. PMID: 28138190.
23. Sari M, Ozmen B, Koyuturk A, et al. A retrospective evaluation of traumatic dental injury in children who applied to the dental hospital, Turkey. Niger J Clin Pract. 2014;17(5):644-8. doi: 10.4103/1119-3077.141438. PMID: 25244279.
24. Kasemkhun P, Smutkeeree A, Jirarattanasopha V. A retrospective comparison of dental treatment under general anesthesia versus non-pharmacological approach in patient with special health care needs. J Dent Sci. 2022;17(3):1238-43. doi: 10.1016/j.jds.2021.11.019. PMID: 35784144.
25. Sheller B, Williams BJ, Hays K, Mancl L. Reasons for repeat dental treatment under general anesthesia for the healthy child. Pediatr Dent. 2003;25(6):246-52. PMID: 1473346.