Changes in aspects of children's oral-health-related quality of life following dental treatment under general anaesthesia.

OBJECTIVES: This study was intended to examine the treatment-associated change in aspects of oral-health-related quality of life (QoL) among children (and their families) undergoing dental rehabilitation under general anaesthesia (GA). METHODS: The parents or caregivers of a consecutive clinical sample of children receiving comprehensive dental treatment under GA at the University of Otago School of Dentistry, Dunedin, and the Christchurch Oral Health Centre, Christchurch, New Zealand, were interviewed by telephone before and after the treatment. Questions were asked relating to the impact of the condition on the child and the family. The post-treatment questionnaire also sought information related to parental satisfaction with the care provided under GA. RESULTS: The parents or caregivers of 95 children participated in the study: 49 had treatment completed at the University of Otago School of Dentistry; and 46 were treated at the Christchurch Oral Health Centre. The child sample comprised 55.8% males and 44.2% females with a mean age of 5.1 years. Their mean dmft was 8.2. A consistent pattern of improvement was found with each indicator used. Complaints of pain, problems with eating and sleeping, and behaviour concerns showed significant improvements, with 100% improvement for children for whom frequent pre-GA problems associated with eating, sleeping and behaviour were reported. Sixty-six parents had to arrange time away from employment on the day of the GA and almost half of those incurred a loss of income. The majority of parents reported a high degree of satisfaction with the care received. CONCLUSIONS: Treating young children with high disease experience in a single session under GA results in immediate improvement in oral health and aspects of their QoL for both the children and their families.

Risk indicators for tooth wear in New Zealand school children.

AIM: To investigate the prevalence and severity of tooth wear in the primary dentition of a representative sample of New Zealand school children and relate these to possible risk factors. DESIGN: A cross-sectional study. SETTING: Primary schools in Dunedin, New Zealand. PARTICIPANTS: 104 children of both sexes, aged between 5 and 8 years, randomly selected. METHODS: Clinical examinations of the buccal, occlusal/incisal and lingual surfaces of deciduous canines and molars. MAIN OUTCOME MEASURE: Degree of wear and the presence of dentinal cupping of teeth. Information on weaning and consumption of fruit-based drinks at bed time, frequency of consumption of fruits, yoghurt, pickled foods, fizzy and fruit-based drinks. RESULTS: The prevalence of tooth wear was similar in boys and girls and there were no significant differences between sides of the arches. A high percentage (82%) of children had at least one primary tooth with dentine exposed. While maxillary canines showed the greatest prevalence of dentine exposed, maxillary molars displayed the greatest prevalence of cupping. Severe tooth wear was less prevalent among children weaned after 12 months (14.3%) than those weaned earlier (27.9% P < 0.01). There were no statistically significant associations between wear and the consumption of fruit, yoghurt, pickled foods, fizzy drinks or fruit-based drinks. CONCLUSIONS: Tooth wear associated with dentine exposure is common in 5-8 year old children. This is not significantly associated with dietary factors, but appears to be related to early weaning from the breast.

Effectiveness of electronic dental anesthesia for restorative care in children.

The effectiveness of electronic dental anesthesia (EDA) for pain control during restorative procedures was compared with local anesthetic injection (LA) in 32 children aged 6 to 12 years. Each child selected had two antimere primary or permanent molars requiring similar-sized Class I or Class II restorations. The pain levels during restorative treatment were assessed using a visual analogue scale. Heart rates and behavior were also recorded. A crossover design was used with each child acting as his/her own control. The results showed that overall, EDA was less effective than LA for cavity preparation. The reported pain scores for EDA were higher in permanent teeth for the deeper cavities, and with one of the operators. The pre- or post-treatment anxiety scores were not found to differ significantly between the two restorative appointments. However, children with the highest pretreatment scores were more likely to report higher pain scores with EDA. Despite this, 63% of the children preferred EDA to LA. Dental anxiety, cavity depth, the tooth being treated, and operator attitude may also be important factors in determining the success of EDA.