Follow-up of children's oral health-related quality of life after dental general anaesthesia treatment.

OBJECTIVE: Our aim was to analyze longitudinally the impact of young children's dental general anaesthesia (DGA) treatment on their OHRQoL and to determine their post-operative oral health status at the six-month follow-up together with parental ratings of their children's oral health. MATERIAL AND METHODS: We conducted a prospective follow-up study of OHRQoL among Lithuanian child patients treated under general anaesthesia (n = 144). The study consisted of clinical dental examinations performed by two examiners at the time of DGA and at the six-month recall, along with OHRQoL surveys and data collected from the patients' files. The dmft index and Silness-Löe plaque index served as clinical measures. The survey tool for assessing the children's OHRQoL was the previously tested Lithuanian version of the ECOHIS. The Wilcoxon signed-rank test served for the statistical analysis (p < 0.05). RESULTS: The ECOHIS scores clearly decreased post-operatively, indicating a significant (p < 0.001) improvement in the children's OHRQoL after the DGA treatment. The ECOHIS scores were lower immediately after the DGA treatment and remained low at the six-month recall. Parents rated their child's oral health as higher after the DGA treatment (p < 0.001). The majority (75%) of the patients had poor or satisfactory oral hygiene at follow-up. CONCLUSIONS: This longitudinal study showed a sustained improvement in the children's OHRQoL six months after their DGA treatment. Post-operative parental ratings of their child's oral health were higher after the DGA treatment, but the children exhibited insufficient oral hygiene and new caries lesions. An appropriate follow-up system for children receiving DGA treatment with special focus on preventive care is needed.

Oral health-related quality of life after dental general anaesthesia treatment among children: a follow-up study.

BACKGROUND: Many young paediatric patients with severe dental caries receive dental treatment under general anaesthesia. Oral health-related quality of life (OHRQoL) can be evaluated to assess the outcome of dental general anaesthesia (DGA) treatment. The aim of our study was to examine the OHRQoL of young Lithuanian children in need of DGA treatment and analyse the impact of DGA treatment on children's OHRQoL. METHODS: We carried out a prospective clinical follow-up study on OHRQoL among all young Lithuanian child patients who received DGA treatment at the Lithuanian University of Health Sciences Hospital during 2010-2012. The study consisted of clinical dental examinations of patients younger than six years, data collected from their patient files, and an OHRQoL survey completed by their parents prior to the child's dental treatment. We conducted a follow-up OHRQoL survey one month after the DGA treatment. The Early Childhood Oral Health Impact Scale (ECOHIS) and its effect size (ES) served to evaluate children's OHRQoL, and the Wilcoxon signed-rank test served for statistical analyses. RESULTS: We obtained complete baseline and follow-up data for 140 and 122 participants, respectively (84.7% follow-up rate). Pain and eating problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. The parents reported greater impacts on boys than on girls. The ECOHIS score decreased significantly (69.5%, p < 0.001) after DGA treatment, revealing a large ES for the child (1.6) and family (2.4) sections of the ECOHIS. CONCLUSIONS: The OHRQoL of young Lithuanian children requiring DGA treatment is seriously impaired. Dental general anaesthesia treatment results in significant improvement of the children's OHRQoL. The children's parents also greatly appreciate this treatment modality for its positive impact on the family's quality of life.

Treatment under dental general anesthesia among children younger than 6 years in Lithuania.

BACKGROUND AND OBJECTIVE: Dental general anesthesia (DGA) is an efficient treatment modality for young pediatric dental patients. The aim of this study was to identify the reasons for DGA, characteristics of patients receiving treatment under DGA, and treatment performed under DGA for children under school age in Kaunas, Lithuania. MATERIAL AND METHODS: The study population comprised all patients younger than 6 years treated under GA for dental reasons (n=144) at the University Hospital during a 3-year period from 2010 to 2012. The data were collected by means of clinical dental examinations, a survey of the parents, and the patients' dental records and included personal background, reasons for DGA, dental status, and treatment provided. RESULTS: More than half (54%) of the children were younger than 4 years; 40% of them resided in cities. The dental caries experience was high: the mean dmft and d were 12.9 (SD, 3.5) and 12.1 (SD 3.9), respectively. The majority (81%) of the children had multiple reasons for DGA, with the need for excessive treatment (93%), followed by dental fear and uncooperativeness (66%), being the most common. The extent of treatment increased with age and was greater among patients from rural areas. Of the 1975 primary teeth treated under GA, 50% were restored, 32% extracted, and 18% targeted with preventive procedures. CONCLUSIONS: Young children with very high levels of untreated tooth decay are treated under DGA at the Lithuanian University of Health Sciences Hospital. The need for complex treatment as well as dental fear and uncooperativeness are the major reasons for DGA. Multiple caries treatments and extractions are performed for these patients. This study highlights a great need to develop the healthcare system with regard to the appropriate management of caries among young children and postoperative DGA care.

Adaptation and validation of the early childhood oral health impact scale in Lithuania.

BACKGROUND: The Early Childhood Oral Health Impact Scale (ECOHIS) is a parent--assessed oral health related quality of life measure developed to assess the impact of oral health problems on preschool children. AIM: The aim of this study was to develop a Lithuanian version of the ECOHIS and evaluate its validity and reliability among preschool children in Lithuania. DESIGN: A lithuanian version of ECOHIS (L-ECOHIS) was developed through a forward-backword translation. A cross-sectional study was performed to assess discriminant and convergent validity and internal consistency. Data was collected from 130 parents of 0-5 year-old children visiting the dental department. A subsample of parents filled the questionnaire again to assess the test-retest reliability. RESULTS: Cronbach's alpha for the instrument was 0.869. Item-total correlation coefficients ranged from 0.389 to 0.797. Scores of the child and family sections were significantly correlated (P<0.001). The scale scores indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health and problem-based dental attendance. The intra-class correlation coefficient was 0.98. CONCLUSION: The L-ECOHIS is a valid and reliable measure to assess OHRQoL of 0-5 year-old children with Lithuanian speaking parents.

Changes in oral health-related quality of life among children following dental treatment under general anaesthesia. A systematic review.

AIM: To review the results of studies reporting data on changes in aspects of children's oral-health-related quality of life (OHRQoL) following dental treatment under general anaesthesia (GA). To describe instruments measuring children's OHRQoL used in the studies. METHODS: A literature review was carried out to identify relevant studies reporting data on changes in aspects of children's OHRQoL following dental treatment under GA. The data was extracted from the selected papers. RESULTS: The review included 11 journal articles, which presented the results of clinical trials. The studies were based on different questionnaires measuring children's OHRQoL and parental satisfaction. CONCLUSIONS: Oral rehabilitation under GA results in the immediate improvement of children's oral health and physical, emotional and social quality of life. It also has a positive impact on the family. However, a more accurate comparison of results is not possible due to differences in instruments used. And no single decision exists on the choice of the instrument measuring children's OHRQoL following dental treatment under GA. It may be concluded that further studies on measuring long term OHRQoL changes and studies surveying children are needed.