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International Poster Journal of Dentistry and Oral Medicine
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Int Poster J Dent Oral Med 10 (2008), No. 2     15. June 2008

Int Poster J Dent Oral Med 2008, Vol 10 No 02, Poster 404

Oral Health State of Handicapped Children Treated under General Anaesthesia

Language: English
 

Authors:
MUDr.LukᚠPantucek, Prof. MUDr. Martina Kukletová, Csc., Ass. Prof. MUDr. Zdenka Halacková, Csc., MUDr. Jarmila Kuklová
Stomatological Clinic, Faculty of Medicine, Masaryk University, Brno, Czech Republic
Prof. MUDr. Lýdie Izakovicová Hollá, PhD.
Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic

Date/Event/Venue:
June 13 - 17, 2007
The 21st Congress of IAPD
Hong Kong
 

Introduction

The treatment of uncooperative children is very difficult and time consuming. It requires a special psychological approach and often pre-medication. If the necessary cooperation is not achieved conscious sedation or, in serious cases, general anaesthesia can be used. Pedodontic department of the Stomatological Clinic in Brno takes care of mentally handicapped children who cannot cooperate due their disability and of children with serious stages of anxiety. Because of un-cooperation and extent of the dentition destruction general anaesthesia was used for the therapy.
 

Objectives

The aim of the study was to compare the oral health status of uncooperative anxious (A) and mentally retarded (MR) children treated under general anaesthesia in the period of 2002-2004 at the Stomatological Clinic, Medical Faculty in Brno.
 

Material and Methods

The dental records of 141 children, 6-19-year-old (mean 11.16 years, SD 2.95) and 28 children 6-year-old and younger (mean 3.73, SD 1.41), were used, the data gathered and evaluated. Fisher exact test was applied to evaluate the significance of results.
 

Fig. 1: Spectrum of observed diagnoses
 

 

 
Fig. 2-5: The operating theatre
 

Results

The dental records of 162 children were assessed.
Children 6-19-year-old: MR versus A: DMFT: 6.16, 4.94, DT: 5.16, 4.26, MT: 0.34, 0.19, FT: 0.61, 0.49, RI (%): 6.27, 7.52. In anxious children the number of teeth indicated for extraction was significantly higher both versus D-teeth (p = 0.0013) and versus erupted teeth (p = 0.005).
Children 6-year-old and younger: MR versus A: dmft: 7.57, 5.29 (p = 0.013), dt: 7.29, 4.9 (p = 0.0088), mt: 0.0, 0.29, ft: 0.29, 0.1, ri (%): 3.17, 2.38. In MR children the number of teeth indicated for extraction was significantly higher both versus d-teeth (p = 0.029) and versus erupted teeth (p = 0.00046).
 

Table 1: Dental status in mentally retarded children 6-19 years old
Patients 6-19 year-old treated under general anaesthesia 2002-2004

Mentally retarded Boys Girls All
No. of children 35 26 61
Mean age and SD 11.90 3.42 11.79 3.17 11.85 3.29
  Mean (Total) SE Mean (Total) SE Mean (Total) SE
Erupted permanent teeth 20.29 (710) 1.22 19.42 (505) 1.35 19.92 (1215) 0.90
D Teeth 5.26 (184) 0.79 5.04 (131) 0,61 5.16 (315) 0.52
For extraction 0.94 (33) 0.20 0.65 (17) 0.17 0.82 ↓ (50) 0.13
F Teeth 0.51 (18) 0.22 0.73 (19) 0.25 0.61 (37) 0.17
M Teeth 0.34 (12) 0.15 0.46 (12) 0.19 0.39 ↑ (24) 0.12
DMF Teeth 6.11 (214) 0.96 6.23 (162) 0.88 6.16 (376) 0.66
Restorative index % 5.46 1.96 7.35 2.35 6.27 1.50
↑ ↓ significant differences (P<0,05);
P2 < 0.05; differences in MR and anxious children: versus D-teeth p=0.0013, versus erupted teeth p=0.005
 

Table 2: Dental status in mentally retarded children under 6 years
Patients 6-year-old and younger treated under general anaesthesia 2002-2004

Mentally retarded Boys Girls All
No. of children 2 5 7
Mean age and SD 3.91 2.34 3.48 1.53 3.61 1.59
  Mean (Total) SE Mean (Total) SE Mean (Total) SE
Primary teeth 18.5 (37) 1.50 19.60 (98) 0.40 19.29 (135) 0.47
D Teeth 5.50 (11) 1.50 8.00 (40) 1.58 7.29 ↑ 1 (51) 1.23
For extraction 4.00 (8) 0.00 6.20 (31) 1.98 5.57 ↑ 2,3 (39) 1.43
F Teeth 1.00 (2) 1.00 0.00 (0) 0.00 0.29 (2) 0.29
M Teeth 0.00 (0) 0.00 0.00 (0) 0.00 0.00 (0) 0.00
DMF Teeth 6.50 (13) 2.50 8.00 (40) 1.58 7.57 ↑ 4 (53) 1.25
Restorative index ri 11.11 11.11 0.00 0.00 3.17 3.17
↑ ↓ significant differences (P<0,05);
* Pcorr < 0.05 differences in anxious and MR children
1 p=0.0088
2 versus d-teeth p=0.029
3 versus erupted teeth p=0.00046
4 p=0.013
 

Table 3: Dental status in anxious children 6-19 years old
Patients 6-19 year-old treated under general anaesthesia 2002-2004

Anxious Boys Girls All
No. of children 34 46 80
Mean age and SD 10.00 2.20 10.80 2.85 10.46 2.61
  Mean (Total) SE Mean (Total) SE Mean (Total) SE
Erupted permanent teeth 15.21 (517) 1.30 17.93 (825) 1.04 16.78 (1342) 0.83
D Teeth 3.76 (128) 0.53 4.63 (213) 0.51 4.26 (341) 0.37
For extraction 4.35 (35) 0.47 4.15 (55) 0.48 4.24 ↑ 1,2 (90) 0.34
F Teeth 0.15 (5) 0.09 0.74 (34) 0.22 0.49 (39) 0.13
M Teeth 0.03 (1) 0.03 0.30 (14) 0.15 0.19 ↓ 3 (15) 0.09
DMF Teeth 3.94 (134) 0.54 5.67 (261) 0.67 4.94 (395) 0.46
Restorative index % 3.38 1.97 10.58 2.93 7.52 1.91
↑ ↓ significant differences (P<0,05);
P1, 2 < 0.05; differences in MR and anxious children: versus D-teeth p=0.0013, versus erupted teeth p=0.005
P3 < 0.05; differences in MR and anxious children: p=0.016
 

Table 4: Dental status in anxious children under 6 years
Patients 6-year-old and younger treated under general anaesthesia 2002-2004

Anxious Boys Girls All
No. of children 11 10 21
Mean age and SD 4.26 1.06 3.33 1.45 3.82 1.32
  Mean (Total) SE Mean (Total) SE Mean (Total) SE
Primary teeth 20.00 (220) 0.00 18.60 (186) 0.60 19.3 (406) 0.32
D Teeth 5.18 (57) 1.14 4.60 (46) 0.73 4.90 ↓ 1 (103) 0.68
For extraction 2.82 (31) 0.90 2.80 (28) 0.59 2.81 ↓ 2,3 (59) 0.54
F Teeth 0.18 (2) 0.18 0.00 (0) 0.00 0.10 (2) 0.10
M Teeth 0.36 (4) 0.36 0.20 (2) 0.20 0.29 (6) 0.21
DMF Teeth 5.73 (63) 1,05 4.80 (48) 0.83 5.29 ↓ 4 (111) 0.67
Restorative index ri 4.55 4.55 0.00 0.00 2.38 2.38
↑ ↓ significant differences (P<0,05);
* Pcorr < 0.05 differences in anxious and MR children
1 p=0.0088
2 versus d-teeth p=0.029
3 versus erupted teeth p=0.00046
4 p=0.0136
 

Conclusions

The results of the study have demonstrated that there are statistically significant differences in the data on the oral health state between anxious children who are healthy and mentally retarded ones. In both groups the data are substantially higher than those of common population. Preventive programs with the oral health care education should be offered for handicapped children and their parents/caregivers and especially for anxious children who refuse dental examination and treatment.
 

Literature

  1. Koch G., Modeer T., Poulsen S., Rasmussen P.: Pedodontics-A Clinical Approach. Munksgaard. Copenhagen. 1991.
  2. Lenarda R., Cadenaro M., Stacchi C.: The influence of dentist's behavior on compliance and fear in pediatric dental patients. Europen Journal Of Pediatric Dentistry 4/2000, 2000, s.179-183.
  3. Nováková K., Andresová S.: Occurrence of affective disorders in hendicapped patients (in Czech). Cs. Stomatologie 92, 1992, c.1, pp..31-35.
  4. Quinonez R., Santos R.G., Boyar R., Cross H.: Temperament and trait anxiety as predictors of child behavior prior to general anesthesia for dental surgery. Pediatric Dentistry 19:6, 1997, s.427-431.
  5. Vinckier F., Gizani S., Declerck D.: Comprehensive dental care for children with rampant caries under general anaesthesia. IAPD 11, 2001, s.25-32
  6. Welbury R. D.: Paediatric Dentistry. Oxford Medical Publications. New York. 1997.
     

Abbreviations

A = anxious children
GA = general anaesthesia
MR = mentally retarded children
 

This Poster was submitted by MUDr. LukᚠPantucek.
 

Correspondence address:
MUDr. LukᚠPantucek
Stomatological Clinic
Faculty of Medicine, Masaryk University
Pekarska 53
656 91 Brno
Czech Republic