Retrospective analysis of dental treatment under general anesthesia among children with early childhood caries in Malaysia.

Many children are affected by early childhood caries (ECC) with some requiring dental treatment under general anesthesia (GA). In pediatric dentistry, GA is one of the established methods of behavior management. GA data is useful for understanding the caries burden among young children. This study aimed to determine the trends, patient characteristics, and types of treatments conducted under GA among young children in a Malaysian dental hospital over a 7-year period. A retrospective study using pediatric patient records from 2013 to 2019 was conducted on children aged 2-6 years (24-71 months) having ECC. Relevant data were collected and analyzed. In total, 381 children with a mean age of 49.8 months were identified. Some of the ECC cases were associated with abscesses (32.5%) and multiple retained roots (36.7%). Over a 7-year period, there was an upward trend of preschool children receiving GA. Of the 4713 carious teeth treated, 55.1% were extracted, 29.9% were restored, 14.3% had preventive procedures, and 0.4% were pulp treated. Mean extractions were significantly higher among preschoolers compared to toddlers (p = 0.001), while preventive treatment was markedly higher among toddlers. In terms of the type of restorative materials, almost similar distribution was observed between the two age groups with 86.5% treated using composite restorations. Dental treatment under GA was more frequently used among preschoolers than in toddlers, with extractions and restoration with composite resin being the common treatment options. The findings can help decision-makers or relevant parties address the burden of ECC and enhance oral health promotion activities.

Dental procedures and operating time under day-care general anesthesia among medically compromised and uncooperative pediatric patients.

OBJECTIVE: To analyze dental procedures and operating time provided to medically compromised and uncooperative pediatric patients under general anesthesia (GA). METHOD AND MATERIALS: This cross-sectional retrospective study reviewed hospital records of pediatric patients treated under day-care GA at a Malaysian university hospital between January 2013 and December 2019. Dental procedures were categorized into preventive, restorative, pulp therapy, extraction, and surgical procedures. Age groups were categorized into < 6 years (primary), 6 to 12 years (mixed) and > 12 years old (permanent), to represent different dentitions. The treatment and operating times under GA were compared between age groups, sex, and medical conditions. RESULTS: A total of 595 patients (455 uncooperative healthy and 140 medically compromised) were included in the study. The mean age of the patients was 5.7 years. Male patients (58.3%) outnumbered female patients (41.7%). The most frequently performed procedure was primary tooth extraction. A higher number of surgical procedures were performed on children aged > 12 years compared to younger age groups (P = .001). Children with medical problems had more preventive (mean 3.85 ± 3.65) than restorative treatments (mean 2.66 ± 2.80) and the results were reversed for healthy children. The mean operating time was 64.71 ± 27.89 minutes. Regardless of health status, children > 12 years old had longer operating times, and the mixed dentition group had the shortest treatment durations. CONCLUSIONS: Different types of dental treatment modalities are provided under GA for pediatric patients and operating time was associated with age group. Findings will be useful to improve efficiency of management of pediatric dental cases under day-care GA.