National Oral Disability Centre, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
CHILD Research Group, Swedish Institute for Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
Int J Paediatr Dent. 2018 Jan;28(1):71-82. doi: 10.1111/ipd.12305. Epub 2017 May 17.
The UN Convention on the Rights of the Child gives all children right to the highest standard of services for treatment and rehabilitation. For children with disabilities, sedation and general anaesthesia (GA) are often indicated for dental treatment; however, accessibility to this varies. The International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) enables a biopsychosocial description of children undergoing dental treatment.
To investigate conscious sedation and GA in children with complex disabilities and manifest caries and analyse how caries, child functioning, and dental service organisation relate to dental GA (DGA), comparing Argentina, France, and Sweden using the ICF-CY.
Quantitative, cross-sectional; data collected through structured interviews, observation, and dental records.
Sedation and DGA were common. Children with limitations in interpersonal interactions and relationships were more likely to have had DGA (OR: 5.3, P = 0.015). Level of caries experience was strongly correlated with experience of DGA. There were significant differences between countries regarding caries prevalence, sedation, DGA, and functional and environmental factors.
Although caries experience and child functioning are important, dental health service organisation had the most impact on the incidence of DGA, and for the use of conscious sedation, for children with complex disabilities.
《联合国儿童权利公约》赋予所有儿童接受最高标准治疗和康复服务的权利。对于残疾儿童，镇静和全身麻醉（GA）通常是牙科治疗的指征；然而，获得这种治疗的机会因国家而异。《国际功能、残疾和健康分类 - 儿童和青年版》（ICF-CY）使我们能够对接受牙科治疗的儿童进行身心社会描述。
调查患有复杂残疾和明显龋齿的儿童中使用的清醒镇静和全身麻醉，并使用 ICF-CY 分析龋齿、儿童功能和牙科服务组织与牙科 GA（DGA）之间的关系，比较阿根廷、法国和瑞典三国的情况。
定量、横断面研究；通过结构化访谈、观察和牙科记录收集数据。
清醒镇静和全身麻醉都很常见。在人际交往和关系方面存在限制的儿童更有可能接受全身麻醉（OR：5.3，P = 0.015）。龋齿经历的严重程度与接受全身麻醉的经历密切相关。三国之间在龋齿患病率、镇静、全身麻醉以及功能和环境因素方面存在显著差异。
尽管龋齿经历和儿童功能很重要，但牙科卫生服务组织对 DGA 发生率的影响最大，对于患有复杂残疾的儿童，清醒镇静的使用也是如此。
