Do paediatric patient-related factors affect the need for a dental general anaesthetic?

Aims The aims were to determine the profile of patients referred for treatment with dental general anaesthetic (DGA) and identify patient-related factors that contributed to a child requiring a DGA.Design setting In total, 42 patients were recruited from new patient assessment clinics at the Edinburgh Dental Institute, Scotland. Prospective questionnaires were given to the patients' caregivers with questions regarding their child's dental anxiety level, ethnicity, level of English spoken and languages spoken at home. Height and weight (BMI) measurements were taken and other information (age, sex, medical history status and postcode for level of social deprivation) were collected from their medical records.Results Compared to the local population, children referred for treatment with DGA had a significantly decreased level of English (p = 0.0001) with an increase in non-English languages at home (p = 0.0004). Patients from minority ethnic groups (p = 0.008) and children from socially deprived areas (p = 0.0001) were significantly overrepresented. Self-reported dental anxiety was high and more common in primary than secondary school-aged children (p = 0.039).Conclusions This study highlighted several patient-related variables that may increase the likelihood of DGA treatment. Further work is required to confirm these associations and develop interventions to reduce the number of children requiring DGAs.

To extract or not to extract? Management of infraoccluded second primary molars without successors.

Infraocclusion is a term used to describe a tooth which has stopped its relative occlusal growth into the arch after the period of active eruption; as a result, the tooth becomes depressed below the occlusal plane. Although many aetiological mechanisms have been proposed, ankylosis is considered the primary cause of infraocclusion. Complex cases benefit from multidisciplinary management. This paper concentrates on the diagnosis and management of infraoccluded second primary molars, without permanent successors and without significant malocclusion, and provides clinicians with a treatment decision tree to aid in treatment planning.