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Pediatric morbidity after oral surgery procedures under general anaesthesia: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101262. [PMID: 35961509 DOI: 10.1016/j.jormas.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/06/2022] [Accepted: 08/07/2022] [Indexed: 11/21/2022]
Abstract
The aim of this study is to carry out a systematic review of the existing literature on postoperative morbidity after general anaesthesia (GA) in the dental care of paediatric patients, its frequency, characteristics and association with the intervention performed. MATERIAL AND METHODS An exhaustive search of the literature published up to 23 February 2022 was carried out in PubMed, Web of Science, Cochrane and EBSCO, with the following strategy: (infant OR child OR adolescent) AND (Oral Surgical Procedures OR Dentistry, Operative) AND Anesthesia, General AND Postoperative Complications. RESULTS The most frequent reason for the indication of general anaesthesia was dental caries and its complications (up to 91.0% of patients), followed by lack of cooperation/anxiety and/or fear for dental procedures in the office (between 39.8 and 47.9%). There is a higher prevalence for treatments in the special patient group reaching 87.7% compared to 63.3% in healthy patients. The main comorbidities recorded were: physical or mental disability, neurological, haematological, cardiac disorders, asthma, Down's syndrome; it was not possible to establish their association with the intervention performed. Regarding complications, complaints occurred between 43.0 and 98.9% of cases within the first 24 hours, the main reason being pain (between 14.0% and 95.0%). CONCLUSIONS Pediatric dental procedures under GA carry a very low risk of major complications, but have a virtually universal incidence of minor complications.
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Sabbagh HJ, Albeladi NH, Altabsh NZ, Bamashmous NO. Risk Factors Associated with Children Receiving Treatment at Emergency Dental Clinics: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1188. [PMID: 36673944 PMCID: PMC9858666 DOI: 10.3390/ijerph20021188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: The process of managing children at the emergency dental clinic (ER-C) is a difficult challenge. This matched case-control study assessed risk factors associated with children visiting the ER-C compared to visits at the regular dental clinic (RD-C). (2) Methods: The participants included 421 children aged three to 12 years who were recruited at the ER-C (cases) and RD-C (controls) at King Abdulaziz University Dental Hospital, with each group matched for gender and age. A data-collection form was developed and validated in both Arabic and English, containing the following four sections: DMFT/dmft index, Frankl’s behaviour rating scale, Dental Neglect Scale, and Dental Care Barriers questionnaire. (3) Results: The ER-C (vs RD-C) group showed significantly more uncooperative behaviour (p = 0.002), a higher total mean dental neglect score (p = 0.003), and a higher dental barrier score (p < 0.001). Binary regression analysis showed that those making their first visit (AOR: 2.65, p < 0.001) and with higher dental barriers (AOR: 1.121, p < 0.001) were statistically significantly more associated with ER-C visitation. (4) Conclusion: These findings suggest that children who visit the ER-C are more prone to dental care barriers, uncooperative behaviour, and dental neglect, thus highlighting the importance of encouraging and planning their attendance to ensure optimal dental care.
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Affiliation(s)
- Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | | | | | - Nada Othman Bamashmous
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 22254, Saudi Arabia
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Khalid G, Metzner F, Pawils S. Prevalence of dental neglect and associated risk factors in children and adolescents-A systematic review. Int J Paediatr Dent 2022; 32:436-446. [PMID: 34585811 DOI: 10.1111/ipd.12923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dental neglect (DN) is characterized within the wider framework of child neglect, though it is under-recognized by professionals. AIM To get an overview of the prevalence of DN worldwide and highlight the possible risk factors associated with it. METHODS A systematic review was conducted according to PRISMA guidelines. Studies on children and adolescents aged 0-19 years were included. Studies were identified by searching in the various scientific databases up to 14 January 2020. RESULTS Ten primary studies were included in which DN or indicators of DN were examined. The prevalence estimate range of DN reported by seven of the included studies after removing the outliers is from 34% to 56%. The prevalence of untreated caries reported by three of the included studies ranged from 38.9% to 99%. The education level and SES of parents and parental attitudes towards dental health affect children's oral health. Moreover, looked-after children and children of refugees are at higher risk of DN. CONCLUSION The study showed a high prevalence of DN and untreated caries. Due to the under-reporting of DN and a limited number of included studies, the results cannot be generalized worldwide. There is a need to make policies that include reporting of DN to higher authorities by dental professionals.
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Affiliation(s)
- Ghazal Khalid
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franka Metzner
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Paediatric dental neglect: a pathway for information sharing. Br Dent J 2022. [PMCID: PMC8916075 DOI: 10.1038/s41415-022-4058-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042380. [PMID: 35206566 PMCID: PMC8872083 DOI: 10.3390/ijerph19042380] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 01/28/2023]
Abstract
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.
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Affiliation(s)
- Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
- Correspondence:
| | | | - Willa Giffin
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - Natasha Hikita
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - José C. Polido
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
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Bradbury-Jones C, Isham L, Morris AJ, Taylor J. The "Neglected" Relationship Between Child Maltreatment and Oral Health? An International Scoping Review of Research. TRAUMA, VIOLENCE & ABUSE 2021; 22:265-276. [PMID: 31043121 DOI: 10.1177/1524838019841598] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Globally, the oral health needs of children who have, or are suspected of having, experienced abuse or neglect has become a focus of concern. It is thus valuable and timely to map the contemporary nature of the research landscape in this expanding field. This review reports the findings of a scoping review of the international empirical literature. The aim was to explore the relationship between child maltreatment and oral health and how this complex issue is addressed in contemporary dental, health, and social work practice. The review identified 68 papers, analysis of which identified three themes: (1) There is a relationship between poor oral health and child maltreatment that is well evidenced but conceptually underdeveloped. (2) There are discrepancies between the knowledge of members of the dental team about child maltreatment and their confidence and aptitude to identify and report child protection concerns. (3) There are areas of local-level policy and practice development that seek to improve working relationships between dentists and health and social work practitioners; however, there is widespread evidence that the oral health needs of this group of vulnerable children are not consistently met. To orientate critical discussion and planning for future research and practice, we present the Patterns, Advances, Gaps, Evidence for practice and Research recommendations (PAGER) framework. The review's findings are likely to be of interest to researchers, practitioners, and policy makers working across dentistry, health and social work.
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Affiliation(s)
| | - Louise Isham
- 1724University of Birmingham, Birmingham, United Kingdom
| | | | - Julie Taylor
- 1724University of Birmingham, Birmingham, United Kingdom
- Birmingham Children's Hospital, NHS Foundation Trust, Birmingham, United Kingdom
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López-Velasco A, Puche-Torres M, Carrera-Hueso FJ, Silvestre FJ. General anesthesia for oral and dental care in paediatric patients with special needs: A systematic review. J Clin Exp Dent 2021; 13:e303-e312. [PMID: 33680333 PMCID: PMC7920568 DOI: 10.4317/jced.57852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/02/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The objective of this study is to conduct a systematic review of the literature on the characteristics, needs and current situation of dental care for pediatric patients with special needs. MATERIAL AND METHODS An exhaustive search for literature published until June 1, 2020. It was carried out using PubMed, Web of Science, Scopus, Cochrane and EBSCO, with the following keywords: Oral Surgical Procedures and Dentistry, Operational and Anesthesia, General Y (Spanish[lang] or English[lang] ) Y (infant[MeSH] Or child[MeSH] Or adolescent[MeSH]). The research was carried out following the PRISMA research methodology. RESULTS The most common indication for general anesthesia (GA) was tooth decay in 16 studies (6.5-90.8% of patients), followed by lack of cooperation and/or fear of dental professionals performing dental procedures in 8 studies. There is a higher prevalence of treatment in the group of patients with special needs, reaching 87.7% compared to 69.9% in healthy patients. CONCLUSIONS In paediatric patients with special needs the use of GA is increasing, monitoring and preventive care are insufficient and withdrawal rates are high. Key words:Oral surgical procedures and dentistry, operational and anesthesia, general.
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Affiliation(s)
- Ana López-Velasco
- DDS. Service of Stomatology, Centro de Especialidades El Grao, Departamento Hospital clínico/Malvarrosa, Valencia; Pediatric dentistry Associate Professor Universidad European de Valencia, Valencia, Spain. Attached Dentist Center Specialties and Clinical/Malvarrosa University Hospital of Valencia. Assistant Professor Department of Pediatric Dentistry European University of Valencia, Valencia, Spain
| | - Miguel Puche-Torres
- MD, PhD. Department of Maxillofacial Surgery, Hospital Clínico Universitario de Valencia, INCLIVA. Associate Professor, Surgery Department, Facultad de Medicina y Odontología Universidad de Valencia, Valencia, Spain. Scopus Author ID: 23477898100. Department Head maxillofacial surgery service, Clinical/Malvarrosa University Hospital of Valencia. Associate Professor, Surgery Department, Faculty of Medicine and Dentistry University of Valencia, Valencia, Spain 3 PharmD. PhD. Pharmacy Service. Hospital Universitario La Plana, Villa-real (Castellón) Spain. Attached Pharmacist University La Plana Hospital of Castellón, Spain
| | - Francisco J Carrera-Hueso
- PharmD. PhD. Pharmacy Service. Hospital Universitario La Plana, Villa-real (Castellón) Spain. Attached Pharmacist University La Plana Hospital of Castellón, Spain
| | - Francisco-Javier Silvestre
- MD, DDS, PhD. Stomatology Unit. Hospital Universitario Dr. Peset de Valencia y Departamento de Estomatología Universidad from Valencia, Valencia, Spain. Attached Stomatologist Hospital Dr. Peset of Valencia. Professor Special Patiens Faculty of Medicine and Dentistry University of Valencia, Valencia, Spain
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Rønneberg A, Nordgarden H, Skaare AB, Willumsen T. Barriers and factors influencing communication between dental professionals and Child Welfare Services in their everyday work. Int J Paediatr Dent 2019; 29:684-691. [PMID: 31077635 DOI: 10.1111/ipd.12507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Among various health professionals, general dental professionals (GDPs) screen children frequently, giving them a unique opportunity to act upon suspicion of child maltreatment. The dental team has received considerable attention regarding safeguarding children. AIM The aims of this study were to explore whether GDPs have mutual collaboration and communication with the Child Welfare Services (CWS), and potential barriers for reporting child maltreatment. DESIGN An electronically pre-coded questionnaire was sent to all GDPs (n = 131) in the Public Dental Health Service (PDHS) in Oslo. Frequency distributions and statistical analysis were carried out by chi-squared statistics and multivariate logistic regression analysis. RESULTS The response rate was 75%. Ninety per cent of GDPs had received requests from CWS to provide a child's dental chart. General dental professionals reported child maltreatment frequently (71%), but CWS only gave feedback in 55% of the cases. Uncertainty was the most common reason for not reporting and 33% of the GDPs had chosen not to send a report despite suspicion. Using guidelines increased frequency of reporting (OR 3.6). CONCLUSIONS Mutual collaboration and communication should be improved in the task of safeguarding children. Uncertainty and lack of guidelines may act as barriers for not reporting to the CWS.
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Affiliation(s)
- Anne Rønneberg
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Nordgarden
- TAKO-centre (National Resource Centre for Oral health in Rare Disorders), Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anne B Skaare
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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The Analysis of Dental Treatment under General Anaesthesia in Medically Compromised and Healthy Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142528. [PMID: 31311179 PMCID: PMC6678959 DOI: 10.3390/ijerph16142528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/30/2019] [Accepted: 07/06/2019] [Indexed: 11/20/2022]
Abstract
Dental care under general anaesthesia (GA) is an option when normal treatment cannot be accomplished due to un-cooperation and systemic or cognitive/intellectual disabilities. The purpose of this retrospective cohort study was to analyse the dental treatment under GA in medically compromised and healthy children. The data were collected from the medical records of children who received their dental treatment under GA. The data regarding patient age, sex, general health, and type of treatment were analysed. This clinical trial included 229 study subjects (138 males, 91 females) with an average age of 8.34 (SD 3.78). Counts and relative counts were used for description of qualitative data. The association between the variables was analysed using contingency tables. The significance of the findings was tested by the chi-square test. Most of the children were older pre-school 63 (27.51%) and young school children 102 (44.54%). Medical disability (systemic or intellectual) was diagnosed in 142 children (62.01%); the remaining 87 (37.99%) were healthy children. Dental treatment of primary teeth was more commonly performed in healthy children (65.52%) compared to medically compromised children (58.45%) (p = 0.287). The total number of medically compromised children and the total number of healthy children were both considered to be 100% for the purpose of the following calculations. In terms of permanent dentition, medically compromised children required more extractions and fillings (38.03%, 57.04%) compared to healthy children (14.94%, 17.24%, respectively). The results of this study revealed that dental treatment under GA was more commonly performed in medically compromised children in permanent teeth only in comparison to healthy children. Based on these findings, both health professionals and state authorities should focus more on preventive care in medically compromised children in order to improve their oral health.
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10
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Dental characteristics and according treatments of children under GA in Germany. Eur Arch Paediatr Dent 2019; 20:617-622. [PMID: 31124081 DOI: 10.1007/s40368-019-00447-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Due to rising numbers of dental referral to general anesthesia, more specialized dental treatments under GA were needed in the last decades in Germany. However, there are few studies about it. Therefore, the present study aimed to assess dental treatment and characteristics of the children underwent GA at Greifswald University Clinic in comparison with specialized pediatric private practices in Germany. MATERIALS AND METHODS This analytical comparative research reviewed the records of all children younger than 18 years old, whose underwent GA at the university dental clinic and three private practices in 2011. All cases were analyzed anonymously, including age, gender, caries levels, diagnostics and dental treatments. RESULTS About 54% and 50%, respectively, of children who underwent GA at both the university clinic and private practices were under 5 years old. Dental caries were mostly diagnosed among referred children (47.4% and 33.8% at university and private practices, resp.) followed by irreversible pulpitis (19.2% and 22.4%, resp.) and ECC (14.1% and 20.1%, resp.). Dental extractions were often performed at university clinic (40.2%) followed by fillings (33.9%), while more restorations and less extractions were supplied at private practices (47.8% and 16.3%, resp.). CONCLUSIONS Dental caries and its complications like pulpal problems were the most important reason for children who underwent GA combined with young age (< 5 years). Therefore, a primary preventive approach would be preferable to decrease the number of children in need of comprehensive dental treatment under GA.
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11
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Grindefjord M, Persson J, Jansson L, Tsilingaridis G. Dental treatment and caries prevention preceding treatment under general anaesthesia in healthy children and adolescents: a retrospective cohort study. Eur Arch Paediatr Dent 2018; 19:99-105. [PMID: 29480502 PMCID: PMC5893663 DOI: 10.1007/s40368-018-0332-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 09/19/2017] [Indexed: 12/29/2022]
Abstract
AIM This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. METHODS This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007. Data was extracted from the patient records at the PDS, including variables such as number of dental visits, treatment/prophylaxis prior to GA, number of missed and cancelled appointments, and number of decayed teeth. RESULTS On average, the treatment group had significantly more decayed teeth (p < 0.001) than the control group. Furthermore, the treatment group had significantly more restorations (p < 0.01), had visited the dentist significantly more often (p < 0.001), and had undergone significantly more behaviour management treatment and preventive treatment (p < 0.001). In the treatment group 65% of the children and adolescents, had received no behaviour management treatment and 48%, no preventive treatment. CONCLUSIONS In the Stockholm PDS, over half of the children and adolescents referred by general dentists to paediatric specialists had no behaviour management treatment and nearly half, no preventive treatment, despite receiving significantly more operative treatment compared with matched controls. General dentists should target high caries-risk patients for additional behaviour management and preventive care to reduce the need for treatment under GA.
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Affiliation(s)
- M Grindefjord
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden.,Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - J Persson
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - L Jansson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Periodontology, Public Dental Health Services, Eastmaninstitutet, Stockholm, Sweden
| | - G Tsilingaridis
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden. .,Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Center of Pediatric Oral Health, Stockholm, Sweden.
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Kvist T, Annerbäck EM, Dahllöf G. Oral health in children investigated by Social services on suspicion of child abuse and neglect. CHILD ABUSE & NEGLECT 2018; 76:515-523. [PMID: 29294446 DOI: 10.1016/j.chiabu.2017.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children.
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Affiliation(s)
- T Kvist
- Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Huddinge, Sweden.
| | - E-M Annerbäck
- Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - G Dahllöf
- Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Huddinge, Sweden
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