Kasemkhun Pornpailin, Smutkeeree Apiwan, Jirarattanasopha Varangkanar
Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
J Dent Sci. 2022 Jul;17(3):1238-1243. doi: 10.1016/j.jds.2021.11.019. Epub 2021 Dec 12.
BACKGROUND/PURPOSE: The unmet dental needs are still at the highest rate in patients with special health care needs (SHCN) owing to their physical conditions, lack of cooperation, anxiety and dental fear. This study was aimed to investigate the differences in characteristics and outcomes of dental treatment between general anesthesia (GA) and non-pharmacological approach (NP) in patients with SHCN.
This study reviewed the dental chart records of SHCN patients from 2005 to 2019. The dental chart records were divided into two subgroups: GA and NP groups. The demographic data, recall behavior and treatment outcomes were analyzed and compared between groups. The comparisons between groups were analyzed by Pearson's chi-squared test, Fisher's exact test and Mann-Whitney U test at a significant level of 0.05.
Two hundred and sixty-one patients aged 2.2-43.1 years with mean age 14.22 ± 8.64 years old were included. The proportion of cases treated under GA (62%) and NP (38%) was 1.6:1. General anesthesia group had significantly higher in mean ages, caries experience, definitely negative behavior and treatment needs than NP group ( < 0.001). Moreover, recall rates in GA group were significantly lower than NP group ( < 0.001) without a significant difference in regularity. New caries occurrence ( = 0.015) with faster rate ( = 0.035), and behavior changes was significantly found in GA group ( = 0.007) after 24 months of recall.
Patients with SHCN who were at older age and had high caries experience with definitely negative behavior and numerous treatment needs were more justifiably for GA. A significant new caries occurrence with faster rate tended towards SHCN patients who underwent GA.
背景/目的：由于身体状况、缺乏合作、焦虑和牙科恐惧，特殊医疗需求（SHCN）患者中未满足的牙科需求率仍然最高。本研究旨在调查全身麻醉（GA）和非药物方法（NP）在SHCN患者牙科治疗的特征和结果上的差异。
本研究回顾了2005年至2019年SHCN患者的牙科病历记录。牙科病历记录分为两个亚组：GA组和NP组。分析并比较两组之间的人口统计学数据、复诊行为和治疗结果。组间比较采用Pearson卡方检验、Fisher精确检验和Mann-Whitney U检验，显著性水平为0.05。
纳入了261例年龄在2.2 - 43.1岁之间，平均年龄为14.22±8.64岁的患者。接受GA治疗（62%）和NP治疗（38%）的病例比例为1.6:1。全身麻醉组的平均年龄、龋齿经历、明确的负面行为和治疗需求显著高于NP组（<0.001）。此外，GA组的复诊率显著低于NP组（<0.001），复诊规律性无显著差异。在24个月的复诊后，GA组新龋发生率（=0.015）更快（=0.035），行为变化显著（=0.007）。
年龄较大、龋齿经历高、有明确负面行为且有大量治疗需求的SHCN患者更适合接受GA治疗。接受GA治疗的SHCN患者新龋发生率显著更高且速度更快。
