Variables Affecting General Anesthesia Time for Pediatric Dental Cases.

PURPOSE: The purpose of this study was to identify variables affecting procedural times for dental treatments performed in the operating room (OR) under general anesthesia. METHODS: A total of 2,264 OR cases at Boston Children's Hospital were included in the study. A series of patient, provider, and operational variables were studied, including: patient age, gender, American Society of Anesthesiologists (ASA) class, need for intraoperative radiographs, intubation type, provider type, referring provider type, referral date, waiting time between referral and OR, and symmetry of caries pattern. Analysis of variance, z test, t test, Pearson correlations, and regression modeling were used. RESULTS: Provider inexperience, need for obtaining radiographs, older age, higher ASA class, and oral intubation significantly increased surgical case times. Using the current OR case estimation resulted in an overestimation of 14.6 hours per month. Application of our regression model improved the accuracy of case time estimation by 7.9 hours per month. CONCLUSIONS: Overestimation of pediatric dental operating room cases exists, and identification of variables associated with these inaccuracies can aid providers in recapturing underutilized operating room times.

Hospital-based emergency department visits with dental conditions among children in the United States: nationwide epidemiological data.

PURPOSE: To provide nationally representative estimates of hospital-based emergency department visits (ED) for dental caries, pulp and periapical lesions, gingival/periodontal lesions, and mouth cellulitis occurring among patients who were 21 years old and younger. METHODS: Nationwide Emergency Department Sample (NEDS) for the year 2008 was used. All ED visits with dental conditions were included. Discharge patterns, demographics, disposition following ED visit, and hospital charges, were examined. NEDS is a uniform, stratified dataset, and can be projected to the national level. RESULTS: A total of 215,073 ED visits with dental conditions occurred among children. These visits included diagnosis of dental caries (50 percent of visits), pulpal and periapical conditions (41 percent), gingival (15 percent) and periodontal diseases (five percent), and mouth abscess/cellulitis (three percent). Forty-two percent were covered by Medicaid, and 32 percent were uninsured. Mean charge per visit was $564, and total ED charge across the United States (US) was $104.2 million. Among those hospitalized following ED visits, total hospitalization charge across US was $162 million. CONCLUSIONS: A substantial amount of hospital resources are spent treating dental conditions in the ED. A total of 43 percent of ED visits were covered by Medicaid, and 32 percent were uninsured.