The impact of general medical health status, demographical, and patient-specific variables on need for dental treatment of children and adolescents under general anesthesia.

ABSTRACT

OBJECTIVES: Aim of this retrospective study was to examine the influence of general medical, demographical, and other patient-specific factors on the need for dental treatment under general anesthesia in children and adolescents at Saarland University Hospital. For assessment of the clinical treatment need, a mixed dt/DT (decayed teeth) was introduced. MATERIALS AND METHODS: A total of 340 patients under 18 years of age who received restorative-surgical dental treatment between 2011 and 2022 were anonymously enrolled. Demographic and other patient-specific data, general medical health, oral health, and treatment related data were recorded. In addition to descriptive analysis, Spearman-Rho-test, Mann-Whitney-U-test, Kruskall-Wallis-test and Chi-square-test were used. RESULTS: More than half of the patients (52,6%) were in general health, but non-cooperative. The majority of the patients (66.8%) was between 1 and 5 years of age (p < 0,001). Mean dmft was 10.95 ± 4.118, mean DMFT was 10.09 ± 7.885, and mean dt/DT was 10.79 ± 4.273. Analysis showed that communication difficulties significantly influenced dmft (p = 0.004), DMFT (p = 0.019), and dt/DT (p < 0.001). Type of insurance significantly affected dmft (p = 0.004) and dt/DT (p = 0.001). There was no significant effect of ASA on caries experience, however on prevalence of severe gingivitis (p < 0.001), number of extractions (p = 0.002), and need for repeated treatment (p < 0.001). CONCLUSIONS: Need for dental treatment in the present collective was high, independent of the considered variables. Non-Cooperativeness along with ECC was the main indication for dental general anesthesia. The mixed dt/DT was the most precise survey to evaluate clinical treatment needs. CLINICAL RELEVANCE Given the enormous demand for these rehabilitations with strict selection, it is imperative to create more treatment capacities for patients mandatorily requiring general anesthesia by avoiding it in healthy patients.