Dental treatment of children with special healthcare needs: A retrospective study of 10 years of treatment

IF 2.3 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE International journal of paediatric dentistry Pub Date : 2024-04-09 DOI:10.1111/ipd.13186

Hanna Hieronymus, Selin Aydin, Cornelia Frese, Matthias Huck, Diana Wolff, Caroline Sekundo

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Abstract

Background/Aim

Children with special healthcare needs (CSHCN) often face oral health challenges. This retrospective cross-sectional study at a university hospital aimed to determine CSHCN's medical spectrum, dental treatment needs, and mode of treatment: general anesthesia (GA) or outpatient dental care (ODC).

Design

Data from the Department of Conservative Dentistry, Heidelberg University Hospital, 2012–2022, were reviewed, considering age, gender, International Classification of Diseases-10 diagnoses, caries experience (dmft/DMFT), restorative parameters, and treatment under GA/ODC. For patients under GA, their American Society of Anesthesiologists (ASA) classification was considered. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney U-test and logistic regression were utilized.

Results

Of 669 patients, congenital and chromosomal malformations (34.7%), diseases of the nervous system (19.1%), and mental and behavioral disorders (16.0%) were mainly diagnosed. Dentin caries prevalence was high at 79.1%, with treatments performed mainly under GA (51.4%). The odds of receiving treatment under GA decreased with patient age and increased with higher dmft/DMFT scores. Most under GA were classified as ASA 3 (51.7%), indicating high anesthesia risks.

Conclusion

Children with special healthcare needs often have diseases that can lead to higher challenges related to cooperation. The high prevalence of dentin caries underscores the substantial need for dental treatments, which were consequently often performed under GA, despite the associated risks. These findings stress the need for trained dental professionals.

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有特殊医疗需求儿童的牙科治疗：10 年治疗的回顾性研究

背景/目的有特殊医疗保健需求的儿童（CSHCN）常常面临口腔健康方面的挑战。这项在一所大学医院进行的回顾性横断面研究旨在确定 CSHCN 的医疗范围、牙科治疗需求以及治疗方式：全身麻醉（GA）或门诊牙科护理（ODC）。设计回顾了海德堡大学医院保守牙科 2012-2022 年的数据，考虑了年龄、性别、国际疾病分类-10 诊断、龋病经验（dmft/DMFT）、修复参数以及在 GA/ODC 下的治疗情况。对于接受 GA 治疗的患者，还考虑了他们的美国麻醉医师协会 (ASA) 分级。结果在 669 名患者中，主要诊断为先天性和染色体畸形（34.7%）、神经系统疾病（19.1%）以及精神和行为障碍（16.0%）。牙本质龋齿发病率高达 79.1%，主要在 GA 下进行治疗（51.4%）。接受GA治疗的几率随着患者年龄的增长而降低，随着dmft/DMFT评分的提高而增加。大多数接受 GA 治疗的患者被归类为 ASA 3 级（51.7%），这表明麻醉风险较高。牙本质龋齿的高发病率凸显了对牙科治疗的巨大需求，因此，尽管存在相关风险，但这些治疗通常都是在全麻下进行的。这些发现强调了对训练有素的牙科专业人员的需求。

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来源期刊

International journal of paediatric dentistry 医学-小儿科

CiteScore

5.50

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Paediatric Dentistry was formed in 1991 by the merger of the Journals of the International Association of Paediatric Dentistry and the British Society of Paediatric Dentistry and is published bi-monthly. It has true international scope and aims to promote the highest standard of education, practice and research in paediatric dentistry world-wide. International Journal of Paediatric Dentistry publishes papers on all aspects of paediatric dentistry including: growth and development, behaviour management, diagnosis, prevention, restorative treatment and issue relating to medically compromised children or those with disabilities. This peer-reviewed journal features scientific articles, reviews, case reports, clinical techniques, short communications and abstracts of current paediatric dental research. Analytical studies with a scientific novelty value are preferred to descriptive studies. Case reports illustrating unusual conditions and clinically relevant observations are acceptable but must be of sufficiently high quality to be considered for publication; particularly the illustrative material must be of the highest quality.