Repeat general anaesthesia, a 6-year follow up.

OBJECTIVE: To investigate the number of children who subsequently required further dental general anaesthesia (DGA) following the baseline DGA for exodontia in 1997 over the next 6 year period, and identify any common factors related to these repeat DGAs. DESIGN: A retrospective longitudinal analysis. MATERIALS AND METHODS: Records from a UK teaching hospital for patients who had extractions under DGA within the calendar year of 1997 were identified and analysed. The individual's demographic details, reasons for the baseline DGA, teeth extracted, number of subsequent DGAs, the reasons for repeat DGA and finally any episodes of pain and/or infection after 1997 were recorded. RESULTS: During 1997, a total of 484 children with mean age of 6.35 (ranged between 1 and 16 years) received a DGA for exodontias. The most common reason for the exodontias carried out at this baseline DGA was dental caries and mean number of exodontias was 4.24. Of the total study population 8.9% subsequently had at least one unplanned repeat DGA, with dental caries being a factor in 84% of the cases. Of the subsequently extracted teeth 71.9% were caries free or unerupted at the time of the initial DGA. Of the children who had a repeat DGA, 61% had experienced at least one episode of pain and/or infection subsequent to the first episode of DGA. The pattern of the child's attendance and the recorded experience of oral pain and infection after the baseline DGA in 1997 were variables proved to be strongly associated with the risk of having an unplanned repeat DGA, with the children who were irregular attenders having a four times increased risk. CONCLUSIONS: Two common factors were identified which might predict the potential for a child requiring a repeat DGA; irregular attendance and oral pain and infection.

Enamel defects and ectopic eruption in a child with Usher syndrome and a cochlear implant.

BACKGROUND: Usher syndrome is a genetic disorder consisting of progressive loss of vision and hearing. CASE REPORT: The paper describes an 8-year-old girl with Usher syndrome type I who presented with generalized defects of the permanent dentition and ectopic eruption of the right maxillary first permanent molar. A cochlear implant had been fitted for her hearing loss, and the report reviews the implications of this device for dental treatment. The impacted first permanent molar was encouraged to erupt into the correct position by shaving the distal surface of the second primary molar. CONCLUSION: This is the first report to describe in detail an association between Usher syndrome and enamel defects.

Paediatric dentistry in the new millennium: 2. Behaviour management--helping children to accept dentistry.

Children's dentistry can be a challenge for both the patient and the dentist. The way a dentist interacts with the child patient will have a major influence on the success of any clinical or preventive care. In order to deliver high-quality dentistry to a child whilst also developing a positive attitude towards dental health, the dentist should have a good understanding of the factors that might affect the behaviour of children in the dental setting. A working knowledge of strategies to minimize anxiety and make positive behaviour more likely is essential, as is a grasp of how best to deal with anxiety or negative behaviour.