A Retrospective Study of Paediatric Dental Patients Treated under General Anesthesia

Dental care under general anesthesia (DGA) was found to be a safe, efficient and effective quality treatment for children. Purpose: To describe the characteristics of child dental patients treated under DGA and describe the indications of the treatments and types of treatments provided. Method: The sample consisted of 40 patients treated under DGA at Department of Paediatric Dentistry of school and Hospital of Stomatology of Wuhan University between June 2011 and December 2012. Detailed information was collected from dental records. SPSS software package was used for statistical analysis. Results: The age of the patients ranged from 2.5 years to 24.1 years. Males were more common than females M:F 1.5:1 .The mental retardation patients accounted for (5%) of the sample. The most common indication was inability to cooperate and accept dental treatment under local anesthesia (95%). The treatments rendered included: caries restorations (37%), root canal treatments (34%), extractions (7%), fluoride application (6%), fissure sealants (6%), indirect pulp capping (5%), stainless steel crowns (4%), pulpotomies (0.8%) and labial frenectomy (0.1%). In the follow-up visit fillings were found to be lost in 3 patients, with 2 anterior teeth and one posterior tooth. Conclusion: Caries restoration and root canal treatments were the most common treatments provided. Preventive strategies should be targeted toward children to reduce the number of healthy children receiving treatment under general anesthesia. Clinical significance: This study provides baseline information regarding the types of treatments for paediatric dental patients inWuhanand it is hoped that the data from this study will be useful for other researchers.

Perioperative Dental Injuries: A Retrospective Analysis of Documented Injuries at Penn State Hershey Medical Center

Background: Dental injury is the most common cause of malpractice claims against anesthesiologists in the United States. This study analyzed the incidence, risk factors, and consequences of dental injury directly attributed to anesthetic care at the Penn State Hershey Medical Center. Methods: Data was collected from retrospective chart review of available dental injury records, incident reports, and filed dental claims from January 2008 to June 2014. Results: Forty seven dental injuries were documented amongst 247,323 general anesthetics representing an overall incidence of 0.019%. Seventy percent of injuries occurred in patients with documented pre-existing prosthodontics or poor dentition and largely involved maxillary teeth (68%). Dental fracture (40%) and avulsion (40%) were the most common types of injury. Direct laryngoscopy was used in 60% of cases reporting dental injury;more than one attempt at securing the airway was required in 36% of cases. Total costs related to the injuries were $24347.65. Conclusions: Dental injury is often attributed to the actions of the anesthesiologist. The injury may be unnoticed until after surgery, what makes it difficult to identify the time and mechanism of injury. Our results suggest that the number of attempts at securing an airway is a risk factor for dental injury. Proper preoperative documentation of poor dentition, discussion with the patient about the increased risk of dental injury and detailed documentation of dental injury when it occurs is advised.

家长接受儿童牙科全麻技术的可能影响因素分析

目的:分析影响家长接受儿童牙科全麻技术(dental general anesthesia,DGA)的可能因素,为临床实践中建议家长选择DGA技术时提供参考。方法:向299例被调查对象(患儿的父亲或母亲)解释DGA技术,然后由一名家长完成问卷表。应用100mm可视水平比例尺(visual analogue scale,VAS)判定接受度,线段的最左端表示完全接受(0mm),最右端表示完全不接受(100mm),受试对象在线段上做出标记,测量VAS线段最左端到标记点之间的距离即为接受度。应用SPSS11.0软件包进行统计学分析。父亲和母亲对DGA接受度的差异比较采用χ2检验;DGA的接受度与可能的影响因素之间的相关性采用Spearman相关分析。结果:父亲和母亲对DGA的接受度之间无显著差异,χ2=1.062,P>0.05。Spearman相关分析显示,DGA的接受度与儿童的年龄,父亲或母亲的年龄、文化程度以及儿童的看牙频率等因素无相关关系,P>0.05;母亲DGA的接受度与收入呈正相关,与孩子的配合度的评分呈负相关,P<0.05。结论:父亲和母亲在选择接受DGA时考虑的因素不同,收入和儿童的配合情况是影响母亲接受DGA的重要因素;医生在临床工作中要注意对患儿的父亲和母亲同时做好DGA的知情同意;家庭收入问题是目前我国家长不易接受DGA的一个重要因素。

178名儿童口腔医生对笑气镇静及全麻的认知调查

目的:了解儿童口腔医生对笑气镇静及全麻的认知情况。方法:2012-06对参加第七次全国儿童口腔医学会议的178名医生进行笑气镇静及全麻认知情况问卷调查,并对相关因素进行分析。结果:178名医生中有25人(14%)独立开展过笑气镇静;42人(23.6%)在麻醉医生的合作下开展过全麻技术;38人(21.3%)接受过不同程度的笑气镇静专科培训。医师工作所在省市GDP位于全国前10位的92名医生中有30人(32.6%)在麻醉医师合作下开展全麻技术,位于10位以后的86名医生中仅有12人(13.9%)开展过全麻技术。笑气镇静和全麻的优点,85人(47.8%)选择了避免患儿产生心理阴影;笑气镇静和全麻的缺点,选择医疗费用高,操作难度大,会出现麻醉意外分别为33.7%,29.2%,27.5%;175名(98.3%)医生在以后的工作中会建议病人使用笑气镇静或全麻。结论:目前国内开展笑气镇静及全麻技术的程度较低,可能与国内经济教育发展水平相对不高有关。