Norderyd Johanna, Klingberg Gunilla, Faulks Denise, Granlund Mats
a National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education , Jönköping , Sweden.
b CHILD Research Group, School of Health and Welfare, Swedish Institute for Disability Research, Jönköping University , Jönköping , Sweden.
Disabil Rehabil. 2017 Dec;39(24):2484-2491. doi: 10.1080/09638288.2016.1236406. Epub 2016 Nov 22.
To describe and analyse dental care and treatment modalities for children with complex disabilities from a biopsychosocial perspective, with special focus on dental treatment under general anaesthesia (GA) and its relationship to child's functioning.
An ICF-CY Checklist for Oral Health was completed using structured interview, direct observations, and dental records for patients attending a specialist paediatric dentistry clinic. Descriptive and comparative data analysis was performed. Performance qualifiers from the ICF-CY component Activities and participation were used to calculate functional factors.
Median referral age was 1.5 years and the majority were referred by their paediatrician. Almost all visited a dental hygienist regularly. Dental treatment under GA was common and was combined in 78% of sessions with medical treatment. Children with limitations in their interpersonal interactions and relationships were most likely to have dental GA.
Children without caries experience had been referred for specialist dental care at an earlier age than children with caries experience. GA was a common treatment modality and dental and medical treatments were coordinated under the same GA for a majority of children. By using the ICF-CY, it was possible to identify functional limitations characterising children with disabilities that require dental treatment under GA. Implications for Rehabilitation Early referral to a specialist in paediatric dentistry is valuable for oral disease prevention in children with disabilities. Availability of dental treatment under general anaesthesia (GA) is also important. Combining dental and medical interventions during the same GA session optimises resources both for the individual and for the health organisation. Children with limitations in interpersonal interactions and relationships are more likely to need dental treatment under GA than other children.
从生物心理社会角度描述和分析患有复杂残疾儿童的牙科护理及治疗方式，特别关注全身麻醉（GA）下的牙科治疗及其与儿童功能的关系。
使用结构化访谈、直接观察以及专科儿科牙科诊所患者的牙科记录，完成了一份国际功能、残疾和健康分类儿童版（ICF-CY）口腔健康检查表。进行了描述性和对比性数据分析。使用ICF-CY活动与参与部分的表现限定值来计算功能因素。
转诊的中位年龄为1.5岁，大多数由儿科医生转诊。几乎所有儿童都定期看牙科保健员。GA下的牙科治疗很常见，78%的疗程中牙科治疗与医疗治疗同时进行。人际互动和关系存在限制的儿童最有可能接受牙科GA治疗。
无龋齿经历的儿童比有龋齿经历的儿童更早被转诊至专科牙科护理。GA是一种常见的治疗方式，大多数儿童在同一GA下进行牙科和医疗治疗的协调。通过使用ICF-CY，可以识别出需要在GA下进行牙科治疗的残疾儿童的功能限制。康复启示早期转诊至儿科牙科专科医生对残疾儿童的口腔疾病预防很有价值。全身麻醉（GA）下牙科治疗的可及性也很重要。在同一GA疗程中结合牙科和医疗干预可优化个体和卫生机构的资源。人际互动和关系存在限制的儿童比其他儿童更有可能需要在GA下进行牙科治疗。
