Parental Acceptance Of Children's Dental Treatment Under General Anesthesia And Its Therapeutic Effect

Objective: To investigate parental acceptance of dental general anesthesia(DGA) treatment,and to assess the effects of DGA treatment in terms of postoperative complications,parental satisfaction,postoperative reexamination,and the impact on oral health-related quality of life(OHRQoL) of children.Methods:(1)Five hundred and forty-four parents of children who were eligible for DGA treatment were selected by convenient sampling,and questionnaires were sent to them and recovered on the spot.Visual analogue scale(VAS) was applied to measure the acceptance degree.The data were collected and analyzed by SPSS 20.0 statistically.The parental acceptance degree was described statistically,and the influence factors were tested by single factor(Wilcoxon rank test and Kruskal-Wallis rank test) and multiple factor(multiple linear regression) analysis.(2)One hundred and fifty-nine 2-to 5-year-old children who received DGA treatment were recruited into the experimental group.On the operation day,their background information and preoperative decayed,missing and filled teeth(dmft) data were recorded.After a day and one month,their postoperative complications and parental satisfaction were investigated respectively.Six months later,they were reached out to by the hospital for consulting,and the dmft data and the success rate of treatment procedures(the number of successful procedures / the total number of procedures) were evaluated.Early childhood oral health impact scale(ECOHIS) was used to measure OHRQoL according to the baseline and at the time of one month,three months and six months after the treatment.The higher the score was,the more seriously the quality of life was affected.The matched control group was established against the experimental group which finished the OHRQoL survey to avoid the influence of confounding factors.Children in the control group were eligible for DGA treatment,but they giva up the treatment because their parents refused.Their background information and dmft data were recorded at the first visit.ECOHIS was also used to measure OHRQoL in the control group at the first visit and at the time of one month,three months and six months after the first visit.Results:(1)The mean VAS value was(43.80±29.49)mm,and only 17.8% of the parents had a high acceptance with DGA treatment(VAS value was in 76 ? 100 mm).According to the analysis,whether parents have experienced general anesthesia,whether parents have heard of DGA treatment,parental cognition of whether DGA treatment impaired children's intellectual development,parental cognition of whether DGA treatment impaired children's memory,and parental cognition of anesthesia methods of DGA treatment were the main factors affecting the acceptance.(2)In the experimental group,153,153,117 and 151 children completed the survey of postoperative complications,parental satisfaction,postoperative re-examination and OHRQoL respectively.One or more postoperative complaints on day one were reported by 115(75.2%) children in the experimental group.The most common complaint was sleepiness(43.1%),followed by emergence agitation(38.6%),nausea/vomiting(13.7%),dizziness(12.4%) and fever(4.6%).One hundred and thirty(85.0%) parents were satisfied with the DGA treatment.At postoperative reexamination,children's dmft data was 9.98±4.69 and significantly higher than the baseline(P=0.005).The success rates of resin composites,stainless steel crowns,indirect pulp capping,pulpectomy,space maintenance and dental sealants were 89.6%,96.3%,96.0%,94.4%,76.9% and 92.9%,respectively.At the baseline,mean ECOHIS scores of the experimental group and the control group were 10.57±6.78 and 10.77±6.67 respectively,and there was no significant difference between the two groups(P =0.779).At the time of one month,three months and six months after the treatment(first visit),mean ECOHIS scores in the experimental group were significantly lower than those in the control group.Conclusion:(1)Parents in Chongqing have a low acceptance with DGA treatment,and its influence factors are manifold.When DGA treatment is recommended to parents of children who need it,clinicians should introduce relevant knowledge actively and improve parental cognition,so that they can make more favorable choices for themselves and their children.(2)DGA treatment can get better clinical outcomes and higher parental satisfaction.However,children may experience multiple complications and recurrence of dental caries after the treatment.Therefore,in clinical practice,we should notice the indications of DGA treatment attentively,evaluate the condition of the children carefully,select reasonable and effective treatment procedures,and provide appropriate oral health guidance and follow-up strategies to patients.