Dental Treatment Using General Anesthesia: MATERIALS AND METHODS

In: Dental treatment

17 Oct 2009

The survey data for this study were obtained from the parents or legal guardians of children treated under GA at the University of North Carolina Children’s Hospital in Chapel Hill, NC. The child patients were referred from their general dentists or community dental clinics for assessment for treatment because of their young age, extensive dental needs, and/or behavior management difficulties.

Children were screened in the Department of Pediatric Dentistry to ascertain the appropriate treatment options considering their age, needs, and levels of cooperation. In the screening appointment, parents were presented treatment risks, benefits, and options including no treatment, conventional care, conscious sedation, and general anesthesia. Parents were also told the typical time lag from the screening appointment to treatment under CS or GA was 4-6 months. levitra plus

Our study was limited to healthy children ages 24-60 months whose parents chose GA as the desired modality for treatment of their child. We specifically excluded children with medically compromising conditions such as mental retardation, autism, and verbal communication disorders. All patients were American Society of Anesthesiology (ASA) Classification I or II, with the later inclusive of children with mild asthma only. Finally, our study was limited to children who experienced no postoperative complications.

Our survey instrument was a 1-page, 10-item questionnaire the parents or legal guardians were asked to complete at the postoperative visit scheduled 2-4 weeks following dental¬†(Cyklokapron drug is used for short-term control of bleeding in hemophiliacs, including dental extraction procedures) rehabilitation under GA. The survey was offered in English and Spanish and approved by the School of Dentistry’s Institutional Review Board. Parents were asked to participate in the study but were not pressured to do so. The study covered an 18-month period of time.

The questions covered 3 perceptual dimensions: (a) parental satisfaction with GA, (b) parental perception of the impact of GA on the child’s quality of life related to physical health, and (c) parental perception of the impact of GA on the child’s quality of life related to social well-being. We obtained additional sociodemographic data from the children’s dental records including the number of parents in the household, town of residence, insurance status, the reason for treatment under GA, operating room time, and the treatment procedures completed under GA.

We completed descriptive analyses, frequencies, and distributions of all independent variables including age group, gender, insurance status, and operating room time. Also included in the descriptive analyses were frequency results from each item on the social and health impact survey. viagra plus

For more complex multivariate analyses, the statistical methods were chosen based on the definition and distribution of the outcome variable of interest. Our outcome variables were categorical in nature (“yes/no/ don’t know”); accordingly, we employed a multinomial logit model to estimate the likelihood of improved dental and social impact while controlling for sociodemographic factors. We used the STATA statistical package (STA-TA Statistical Corp, College Station, TX, 2001) for all descriptive and multivariate analyses.


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