Kvist T, Zedrén-Sunemo J, Graca E, Dahllöf G
Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden,
Eur Arch Paediatr Dent. 2014 Oct;15(5):327-32. doi: 10.1007/s40368-014-0118-z. Epub 2014 Mar 28.
To study if treatment under general anaesthesia (GA) is associated with dental neglect or dental disability.
This was a retrospective study.
Dental records of all children in the age 0-6 years who underwent GA at a specialist paediatric dentistry clinic during 2006-2011 were studied with regard to decayed-missed-filled teeth, traumatic injuries, emergency visits, behaviour management problems and the history of attendance. The final sample consisted of 134 children. Matched controls were selected among recall patients who had not received treatment under GA.
Fishers exact test or Pearson Chi-square test analysed response distribution and comparisons between groups, and for multivariate analyses, logistic regression was used.
The results show that children treated under GA had significantly higher caries prevalence, apical periodontitis and infections due to pulpal necrosis. Dental neglect as well as dental disability was significantly more prevalent in the GA group compared to the control group. In a multivariate analysis with dental neglect as independent factor, dental disability was the only significant factor (p = 0.006).
Children treated under general anaesthesia were significantly more often diagnosed with both dental neglect and dental disability. Dental disability was the only factor significantly related to dental neglect. There is a need for improved documentation in the dental records to better identify dental neglect and dental disability, and also a continued training of dentists regarding child protection.
研究全身麻醉(GA)下的治疗是否与牙齿忽视或牙齿残疾有关。
这是一项回顾性研究。
对2006年至2011年期间在一家专科儿童牙科诊所接受全身麻醉的所有0至6岁儿童的牙科记录进行研究,内容包括龋失补牙、创伤性损伤、急诊就诊、行为管理问题和就诊史。最终样本包括134名儿童。在未接受全身麻醉治疗的召回患者中选择匹配的对照组。
采用Fisher精确检验或Pearson卡方检验分析反应分布和组间比较,多变量分析采用逻辑回归。
结果显示,接受全身麻醉治疗的儿童龋齿患病率、根尖周炎和牙髓坏死引起的感染显著更高。与对照组相比,全身麻醉组的牙齿忽视和牙齿残疾明显更为普遍。在以牙齿忽视作为独立因素的多变量分析中,牙齿残疾是唯一的显著因素(p = 0.006)。
接受全身麻醉治疗的儿童被诊断为牙齿忽视和牙齿残疾的情况明显更为常见。牙齿残疾是与牙齿忽视唯一显著相关的因素。需要改进牙科记录中的文档记录,以更好地识别牙齿忽视和牙齿残疾,同时还需要对牙医进行持续的儿童保护培训。