Caries recurrence after treatment under general anaesthesia for early childhood caries: a retrospective cohort study
- 529 Downloads
- 4 Citations
Abstract
Aim
To evaluate rates of caries relapse and explore factors affecting relapse rates after comprehensive dental treatment under general anaesthesia (GA).
Methods
A retrospective cohort study of children ≤6 years of age at the time of reference GA (RGA) who were in an anaesthetic low risk category [American Society of Anesthesiologists (ASA) classification 1 or 2], and had completed 36 months follow-up period was conducted. Patients’ demographics and dental records were collected. Associations between relapse rate and different factors affecting relapse rates were evaluated.
Results
A total of 278 children with mean age of 47 ± 14 months were included. Over 8 % of children had more than one GA, 88 % attended their post-operative follow-up appointment and 45 % returned for all recall appointments over 3 years. During the 3-year follow-up, the relapse rate was 22 %. ASA-2 children and those with less than full primary dentition present at the RGA were more than twice as likely to experience caries relapse as compared to ASA-1 children (OR = 2.46, 95 % CI 1.33–4.56) and those with mixed dentition present at the RGA (OR = 2.74, 95 % CI 1.27–5.91).
Conclusion
ASA-2 health status and having less than a full primary dentition were major predictors of caries relapse after dental treatment under GA.
Keywords
Dental caries Relapse General anaesthesia Risk factorsNotes
Acknowledgments
The author would like to acknowledge Junmin Yang, Department of Paediatrics, University of Toronto, Mount Sinai Hospital for his statistical support.
Conflict of interest
The authors declare no conflict of interest.
References
- al-Shalan TA, Erickson PR, Hardie NA. Primary incisor decay before age 4 as a risk factor for future dental caries. Pediatr Dent. 1997; 19: 37–41.Google Scholar
- Almeida AG, Roseman MM, Sheff M, Huntington N, Hughes CV. Future caries susceptibility in children with early childhood caries following treatment under general anaesthesia. Pediatr Dent. 2000;22:302–6.PubMedGoogle Scholar
- Amin MS, Harrison RL. A conceptual model of parental behaviour change following a child’s dental general anaesthesia procedure. Pediatr Dent. 2007;29:278–86.PubMedGoogle Scholar
- Amin MS, Harrison RL. Understanding parents’ oral health behaviours for their young children. Qual Health Res. 2009;19:116–27.PubMedCrossRefGoogle Scholar
- Amin MS, Bedard D, Gamble J. Early childhood caries: recurrence after comprehensive dental treatment under general anaesthesia. Eur Arch Paediatr Dent. 2010;11:269–73.PubMedCrossRefGoogle Scholar
- Bagramian RA, Garcia-Godoy F, Volpe AR. The global increase in dental caries. A pending public health crisis. Am J Dent. 2009;22:3–8.PubMedGoogle Scholar
- Berkowitz RJ, Amante A, Kopycka-Kedzierawski DT, Billings RJ, Feng C. Dental caries recurrence following clinical treatment for severe early childhood caries. Pediatr Dent. 2011;33:510–4.PubMedGoogle Scholar
- Camilleri A, Roberts G, Ashley P, Scheer B. Analysis of paediatric dental care provided under general anaesthesia and levels of dental disease in two hospitals. Br Dent J. 2004;196:219–23.PubMedCrossRefGoogle Scholar
- Caufield PW, Cutter GR, Dasanayake AP. Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity. J Dent Res. 1993;72:37–45.PubMedCrossRefGoogle Scholar
- Chi DL, Masterson EE, Carle AC, Mancl LA, Coldwell SE. Socioeconomic status, food security, and dental caries in US children: mediation analyses of data from the National Health and Nutrition Examination Survey, 2007–2008. Am J Public Health. 2014;104:860–4.PubMedCentralPubMedCrossRefGoogle Scholar
- El Batawi HY. Factors affecting clinical outcome following treatment of early childhood caries under general anaesthesia: a 2-year follow-up. Eur Arch Paediatr Dent. 2014;15:183–9.PubMedGoogle Scholar
- Foster T, Perinpanayagam H, Pfaffenbach A, Certo M. Recurrence of early childhood caries after comprehensive treatment with general anaesthesia and follow-up. J Dent Child (Chic). 2006;73:25–30.Google Scholar
- Graves CE, Berkowitz RJ, Proskin HM, et al. Clinical outcomes for early childhood caries: influence of aggressive dental surgery. J Dent Child (Chic). 2004;71:114–7.Google Scholar
- Harris JC, Balmer RC, Sidebotham PD. British Society of Paediatric Dentistry: a policy document on dental neglect in children. Int J Paediatr Dent. 2009.Google Scholar
- Harrison MG, Roberts GJ. Comprehensive dental treatment of healthy and chronically sick children under intubation general anaesthesia during a 5-year period. Br Dent J. 1998;184:503–6.PubMedCrossRefGoogle Scholar
- Mahesh R, Muthu MS, Rodrigues SJ. Risk factors for early childhood caries: a case-control study. Eur Arch Paediatr Dent. 2013;14:331–7.PubMedCrossRefGoogle Scholar
- Mittal R, Sharma M. Assessment of psychological effects of dental treatment on children. Contemp Clin Dent. 2012;3:S2–7.PubMedCentralPubMedGoogle Scholar
- O’Mullane D, Parnell C. Early childhood caries: a complex problem requiring a complex intervention. Community Dent Health. 2011;28:254.PubMedGoogle Scholar
- Peerbhay FB. Compliance with preventive care following dental treatment of children under general anaesthesia. SADJ. 2009;64(442):4–5.Google Scholar
- Peretz B, Ram D, Azo E, Efrat Y. Preschool caries as an indicator of future caries: a longitudinal study. Pediatr Dent. 2003;25:114–8.PubMedGoogle Scholar
- Poureslami HR, Van Amerongen WE. Early Childhood Caries (ECC): an infectious transmissible oral disease. Indian J Pediatr. 2009;76:191–4.PubMedCrossRefGoogle Scholar
- Primosch RE, Balsewich CM, Thomas CW. Outcomes assessment an intervention strategy to improve parental compliance to follow-up evaluations after treatment of early childhood caries using general anaesthesia in a Medicaid population. ASDC J Dent Child. 2001;68(102–8):80.Google Scholar
- Sheller B, Williams BJ, Hays K, Mancl L. Reasons for repeat dental treatment under general anaesthesia for the healthy child. Pediatr Dent. 2003;25:546–52.PubMedGoogle Scholar
- Statistics Canada. Postal Code Conversion File: Catalogue 92-153-GWE Ottawa, ON: Ministry of Industry: Ottawa, ON; (2011).Google Scholar
- Tahmassebi JF, Achol LT, Fayle SA. Analysis of dental care of children receiving comprehensive care under general anaesthesia at a teaching hospital in England. Eur Arch Paediatr Dent. 2014;15(5):353–60.PubMedCrossRefGoogle Scholar
- Taskinen H, Kankaala T, Rajavaara P, et al. Self-reported causes for referral to dental treatment under general anaesthesia (DGA): a cross-sectional survey. Eur Arch Paediatr Dent. 2014;15:105–12.PubMedCrossRefGoogle Scholar
- Tinanoff N, O’Sullivan DM. Early childhood caries: overview and recent findings. Pediatr Dent. 1997;19:12–6.PubMedGoogle Scholar
- Tsai CL, Tsai YL, Lin YT, Lin YT. A retrospective study of dental treatment under general anaesthesia of children with or without a chronic illness and/or a disability. Chang Gung Med J. 2006;29:412–8.PubMedGoogle Scholar
- Tuli A, Singh A. Early childhood caries and oral rehabilitation. A treatment quandary. Eur J Paediatr Dent. 2010;11:181–4.PubMedCrossRefGoogle Scholar
- Weinstein P, Harrison R, Benton T. Motivating mothers to prevent caries: confirming the beneficial effect of counseling. J Am Dent Assoc. 2006;137:789–93.PubMedCrossRefGoogle Scholar