J Am Dent Assoc. 2023 Apr;154(4):311-320. doi: 10.1016/j.adaj.2022.12.008. Epub 2023 Feb 3.
This analysis evaluated the time to first sedation or general anesthesia (GA) encounter for children treated with and without silver diamine fluoride (SDF).
This retrospective cohort study used dental claims of privately insured children from birth through age 71 months with a sedation or GA claim from 2016 through 2020. The exposure was SDF use (yes, no). The outcome was time to first sedation or GA. Descriptive and multivariable negative binomial analysis was performed. The analysis tested the hypothesis that among children who received sedation or GA for their caries treatment, those who received SDF would show a longer time to first sedation or GA than children who did not.
Among 175,824 children included, SDF use increased the time to first sedation or GA encounter by 63 days when treated by different dentists (405 days vs 342 days; P < .001) and by 91 days when treated by the same dentist (337 days vs 246 days; P < .001), after controlling for the effects of age at first encounter, sex, and region of the country.
Children treated with SDF had a longer time to first sedation or GA, which was magnified when treatment was performed by the same dentist.
Within an individualized caries management plan, SDF could provide benefits for patients, dental offices, and health systems.
本分析评估了使用和未使用银氨溶液（SDF）治疗的儿童首次镇静或全身麻醉（GA）的时间。
本回顾性队列研究使用了 2016 年至 2020 年期间接受过镇静或 GA 治疗的私人保险儿童的牙科理赔数据，这些儿童从出生到 71 个月大。暴露因素为 SDF 使用（是，否）。结局为首次镇静或 GA 的时间。进行了描述性和多变量负二项式分析。该分析检验了以下假设：在因龋齿治疗而接受镇静或 GA 的儿童中，接受 SDF 治疗的儿童与未接受 SDF 治疗的儿童相比，首次镇静或 GA 的时间会更长。
在纳入的 175824 名儿童中，当由不同牙医治疗时，SDF 的使用使首次镇静或 GA 治疗的时间增加了 63 天（405 天比 342 天；P <.001），当由同一位牙医治疗时，增加了 91 天（337 天比 246 天；P <.001），控制了首次就诊时的年龄、性别和所在地区的影响。
使用 SDF 治疗的儿童首次镇静或 GA 的时间较长，当由同一位牙医治疗时，这一时间会更长。
在个体化的龋齿管理计划中，SDF 可能为患者、牙科诊所和医疗系统带来益处。
