ABSTRACT
UNLABELLED: The child population in Sweden has changed dramatically during the last 20 years. Changes have also occurred within the Public Dental Service (PDS), regarding the provision of dental care to children and adolescents. All these changes may affect the referral pattern and provision of specialist dental care for children and adolescents. OBJECTIVES: The primary aim of this study was to survey the services provided by specialists in paediatric dentistry in Sweden during 2003. A secondary aim was to compare the results with previous surveys. METHODS: A Web-based survey was sent to all 34 specialist paediatric dentistry clinics and was answered by all clinics. Data were compared with results from the surveys performed in 1983, 1989, and 1996. RESULTS: The number of paediatric dentists had been relatively constant over the last 20 years, whereas the number of children referred to paediatric dentists had increased by 28% since 1983. It was estimated that 1.3% of all children in Sweden are treated at a specialist paediatric dental clinic in 2003. Dental treatment need in combination with behaviour management problems (BMP) was the main reason for referral and occurred in 37% of all referrals. The proportion of medically compromised children/children with disabilities had increased from 6% in 1983 to 22% in 2003. The number of patients treated using sedation and general anaesthesia had increased since 1983, and particularly since 1996. CONCLUSIONS: Despite improvements in dental health among children and adolescents in Sweden during the last 20 years, an increasing number of children are referred for specialist paediatric dental treatment. There is an urgent need to increase the number of specialist paediatric dentists in Sweden in order to ensure the continuation of high quality of dental care for children and adolescents.
Subject(s)
Dental Care for Children/statistics & numerical data , Health Services Needs and Demand/statistics & numerical data , Pediatric Dentistry/statistics & numerical data , Pediatric Dentistry/trends , Adolescent , Adult , Aged , Anesthesia, General/statistics & numerical data , Child , Child Behavior , Child Health Services/statistics & numerical data , Child, Preschool , Conscious Sedation , Dental Health Services/statistics & numerical data , Disabled Children/statistics & numerical data , Female , Humans , Infant , Male , Middle Aged , Referral and Consultation/statistics & numerical data , Surveys and Questionnaires , Sweden , WorkforceABSTRACT
Midazolam is a short-acting benzodiazepine with rapid onset, short duration of action and minimal side effects. The aim of this study was to evaluate the oral administration of midazolam as pre-operative sedation in the dental treatment of uncooperative pediatric patients. Included in the study were 160 children with a mean age of 6.7 +/- 2.6 years (1-14 years), 83 boys and 77 girls. All the patients had been referred for specialist treatment due to behavioral management problems. Treatment was performed in 250 sessions. All the children received an oral dose of 0.2 mg/kg body weight of midazolam. Acceptance of treatment was evaluated according to Rud & Kisling. Local anesthesia followed by restorative treatment and/or extractions constituted more than 90% of the performed treatments. Of the 250 sessions, 63% were performed with total acceptance and 30% with doubtful acceptance. In 7%, no treatment could be performed. No serious complications were registered during or after treatment. All the children were able to leave the clinic one hour after treatment. In conclusion, we consider oral administration of midazolam a safe form of premedication. The route of administration, the short waiting-time and half-life, in combination with a level of sedation that allows treatment to be performed, are the principal advantages of conscious sedation with orally administered midazolam.
Subject(s)
Anesthesia, Dental/methods , Anti-Anxiety Agents/administration & dosage , Conscious Sedation/methods , Hypnotics and Sedatives/administration & dosage , Midazolam/administration & dosage , Administration, Oral , Adolescent , Adolescent Behavior/drug effects , Anesthesia, Local , Anti-Anxiety Agents/pharmacokinetics , Child , Child Behavior/drug effects , Child, Preschool , Cooperative Behavior , Dental Anxiety/prevention & control , Dental Restoration, Permanent , Dentist-Patient Relations , Emotions/drug effects , Female , Half-Life , Humans , Hypnotics and Sedatives/pharmacokinetics , Infant , Male , Midazolam/pharmacokinetics , Time Factors , Tooth Extraction , Treatment OutcomeABSTRACT
A case of ritual mutilation in a fourteen-year-old Ethiopian girl is described. When the girl was three years old she had frequent stomach problems. According to tribal tradition her illness was thought to arise from her mandibular primary canines and these teeth were removed by a medicine man. The extraction damaged the tooth germs of the succedaneous teeth and resulted in deformed permanent canines. This is the first report of a case of dental mutilation from Ethiopia.
