Carson P, Freeman R
Ulster Community and Hospitals Trust, James Street Clinic, Newtownards.
Prim Dent Care. 2000 Oct;7(4):163-7. doi: 10.1308/135576100322578933.
To confirm clinical observations and to investigate the characteristics (demography, dental anxiety status, dental health status, treatment experiences and dental health behaviours) of children attending for dental general anaesthesia (DGA).
A case series design was used in which each consecutive parent and child, referred for DGA, were invited to take part.
Identical protocols for the selection of the sample, administration of the questionnaire and clinical examination were used to ensure comparability. To account for seasonal variation the data were collected during and between the months of January and May in both 1993 and 1997. Two hundred children and their parents were selected in 1993 and 200 in 1997. The parent completed a questionnaire. It enquired of the parent and child demography, parental dental anxiety status, and the child's treatment experiences. Children were asked to complete the Children's Fear Survey Schedule (CFSS) to assess their dental anxiety. The child's caries experience was assessed using the guidelines to standardise the collection of epidemiological data throughout the UK.
Children studied in 1997 compared with 1993 were younger, had more decayed but fewer filled teeth, were more dentally anxious, more likely to present in pain and came from families who were in receipt of Government benefits. A linear regression analysis showed that the children with previous experience of DGA had higher levels of dental caries, fewer filled teeth, were older and attended in 1997. An individual regression for 1993 showed that an additional predictor was child attendance pattern.
These findings confirmed the clinical observations and suggested that children who attend in pain and present for repeated DGA represent a group of children with special dental healthcare needs. There is a need for an integrated dental healthcare service to identify such children and provide appropriate dental care facilities for them.
证实临床观察结果,并调查接受全身麻醉下牙科治疗(DGA)的儿童的特征(人口统计学、牙科焦虑状况、口腔健康状况、治疗经历和口腔健康行为)。
采用病例系列设计,连续转诊接受DGA治疗的每对家长和儿童均受邀参与。
采用相同的样本选择、问卷发放和临床检查方案以确保可比性。为考虑季节变化,于1993年和1997年的1月至5月期间及这几个月之间收集数据。1993年选取了200名儿童及其家长,1997年选取了200名。家长填写一份问卷。问卷询问了家长和儿童的人口统计学信息、家长的牙科焦虑状况以及儿童的治疗经历。要求儿童完成儿童恐惧调查表(CFSS)以评估其牙科焦虑。根据全英国统一的流行病学数据收集指南评估儿童的龋齿经历。
与1993年研究的儿童相比,1997年研究的儿童年龄更小,龋齿更多但补牙更少,牙科焦虑程度更高,更有可能在疼痛时就诊,且来自领取政府福利的家庭。线性回归分析显示,曾接受过DGA治疗的儿童龋齿水平更高,补牙更少,年龄更大,且于1997年就诊。1993年的个体回归分析显示,另一个预测因素是儿童就诊模式。
这些发现证实了临床观察结果,并表明在疼痛时就诊且反复接受DGA治疗的儿童代表了一群有特殊口腔保健需求的儿童。需要一种综合口腔保健服务来识别这类儿童,并为他们提供适当的口腔护理设施。