The Analysis Of Children’s Dental Fear And Dental Treatment Under General Anesthesia

How to manage the recalcitrant children is a tough question the dentist facing. Somechildren show tension even fear during dental treatment, these children suffer from dentalfear. Due to the imperfection of the development and the fear of the unknown, theincidence of dental fear in children is very high. Relevant research has shown that theincidence of children’s dental fear is about70%. Some children can lay down on the chairto receive the treatment peacefully while others not. We need to find out the cause and theeffect factors of the difference.We can use the tell-show-do technique or inhalation of nitrous oxide to deliver caresuccessfully to part of the children. But it’s not always potent enough to treat therecalcitrant children. An upturn in general anesthesia activity was reported in developedcountries in1950’s, but dental treatment under general anesthesia has seldom beenreported in China. Part1The analysis of children’s dental fearAims:To investigate the related risk factors of children’s dental fear.Methods:Design children’s dental fear questionnaire according to children’s psychology andour national conditions. Children were divided into two groups, Group DF and GroupNDF. The questionnaires were answered by the parents stand for their children. The datawere statistically analyzed.Results:1. There were no significant differences on the age and sexual distinction betweentwo groups.2. There were28items in the questionnare. There were significant differences ondevelopmental level, mother’s educational background, family formation, mode ofproduction, dental experience of the parents, temperament types and parents’management type.3. Mode of production, developmental level, mother’s educational background,temperament types and parents’management type were the main influence factors.Conclusions:1. For the preschool children, there was no significant difference on dental fearbetween different genders.2. The temperament types may be the most important risk factors. Developmentallevel, mother’s educational background, mode of production, temperament typesand parents’ management type are important influence factors of children’s dentalfear. Part2Dental treatment of children under general anesthesiaAims:To investigate the characteristics of the children treated under general anesthesia(GA), the indications, types of dental treatment, the operating steps and the complications.Methods:The database for this study involved the children treated under GA Pediatric DentalDepartment of Stomatology Hospital of the Fourth Military Medical University from July2011toJuly2012. Inclusion criteria were obtained the consent, American Society ofAnesthesiologists class I, no contraindication for GA. The information collected includedthe following: gender, age, general health status, number of decayed teeth, type ofprocedure, the duration of the treatment, the complications, follow-up notes and so on.We used endotracheal intubation intravenous-inhalation combined anesthesia for allthe patients. All patients were sent into post-anesthesia ICU after the treatment. Thepatients can discharge after the assessment. Ensure the children have a follow-up visit24hafter the treatment.Results:1. Patient characteristics: There were244children received treatment under GA.Their age ranges from17months to132months and the average age was49.91months. There were120boys and124girls, the average age were51.9months and47.89months.2. Types of dental treatment: There were30.09%received restoration,10.57%received indirect pulp capping,3.57%received pulpotomy-primary teeth,25.17%received root canal therapy,11%received performed mental crown,2.12%received tooth extraction and17.48%received prophylactic treatment. 3. The complications: Five cases accompanied by nausea and vomiting after theextubation. All the treatments were performed successfully and all the scores ofpostanesthetic discharge scoring system outnumbered13.4. The follow-up notes: All the children can cooperate except2younger than18months. There were no secondary caries.Conclusions:1. The most common indication was uncooperative children with extensive caries.2. Dental treatment of children under general anesthesia is a safe method.