Savanheimo Nora, Vehkalahti Miira M
Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P,O, BOX 41, 00014 Helsinki, Finland.
BMC Oral Health. 2014 Dec 15;14:154. doi: 10.1186/1472-6831-14-154.
Dental general anesthesia (DGA) is part of public dental care in Finland, but the intention is to return the patient to routine dental care. The aims of this study were to describe the details of treatments under DGA given to generally healthy children and to explore the outcome of their dental care during a 5-year follow-up, with special focus on preventive care. In particular, we examined the return of the patients to routine dental care, of which, to our knowledge, little is known.
Our prospective 5-year follow-up of generally healthy children (aged 0-13 years) treated under DGA by the Helsinki Public Dental Service in 2004 was based on official dental and general anesthesia documents. The statistical analyses employed chi-square tests, t-tests, Pearson's correlation coefficient (r), Fisher's transformation to test r ≠ 0, and logistic regression modeling.
The most common reason for DGA was uncooperation (82%), followed by dental fear (56%). Filling therapy predominated in the treatments given under anesthesia, and the mean number of treatments per patients was 9.5 (SD = 4.2). Throughout the follow-up, 54% of the patients continued to have co-operation problems and 53% expressed dental fear; 11% of the patients received repeat DGA. The mean follow-up time was 48 (median 52) months. The postoperative review visit was actualized within 1.5 (SD = 0.8) months and the first visit to the home dental clinic of the patients in 12.0 (SD = 11.8) months for the 0-5-year-olds and in 7.2 (SD = 5.9) months for the 6-13-year-olds (p < 0.001). The mean time elapsed to the first need for treatment was 18.5 (SD = 14.1) months. During the follow-up, the mean number of treatments per patient was 5.3 (SD = 4.9); almost all patients (97%) received preventive treatment at one of two visits, but the control of dental fear remained rare.
To return to routine dental care after DGA, most of the generally healthy children in our study still needed special attention due to their uncooperation and dental fear, thus calling for a renewal of practices to treat these patients.
牙科全身麻醉（DGA）是芬兰公共牙科护理的一部分，但目的是让患者回归常规牙科护理。本研究的目的是描述对一般健康儿童进行DGA治疗的详细情况，并探讨他们在5年随访期间的牙科护理结果，特别关注预防性护理。我们尤其考察了患者回归常规牙科护理的情况，据我们所知，这方面了解甚少。
我们对2004年由赫尔辛基公共牙科服务机构进行DGA治疗的一般健康儿童（0至13岁）进行了为期5年的前瞻性随访，随访基于官方牙科和全身麻醉文件。统计分析采用卡方检验、t检验、皮尔逊相关系数（r）、用于检验r≠0的费舍尔变换以及逻辑回归建模。
DGA最常见的原因是不合作（82%），其次是牙科恐惧（56%）。麻醉下进行的治疗中充填治疗占主导，每位患者的平均治疗次数为9.5次（标准差=4.2）。在整个随访期间，54%的患者仍存在合作问题，53%表示有牙科恐惧；11%的患者接受了重复DGA。平均随访时间为48个月（中位数52个月）。0至5岁患者术后复查在1.5个月内（标准差=0.8）进行，首次到家庭牙科诊所就诊在12.0个月内（标准差=11.8）；6至13岁患者分别为7.2个月（标准差=5.9）（p<0.001）。首次需要治疗的平均时间为18.5个月（标准差=14.1）。在随访期间，每位患者的平均治疗次数为5.3次（标准差=4.9）；几乎所有患者（97%）在两次就诊中的一次接受了预防性治疗，但对牙科恐惧的控制仍然很少见。
为了在DGA后回归常规牙科护理，我们研究中的大多数一般健康儿童由于不合作和牙科恐惧仍需要特别关注，因此需要更新治疗这些患者的方法。
