scholarly journals The structure of dental procedures under general anaesthesia in children and adolescents with epilepsy

2014 ◽  
Vol 124 (1) ◽  
pp. 29-32
Author(s):  
Małgorzata Tkaczuk-Płocica ◽  
Jolanta Szymańska ◽  
Joanna Rosiak
Keyword(s):  
Children And Adolescents ◽  
General Anaesthesia ◽  
Dental Care ◽  
Dental Treatment ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Treatment Needs ◽  
Deciduous Dentition ◽  
Occlusal Surfaces ◽  
Patients With Epilepsy

Abstract Introduction. One of the indications for dental treatment in general anaesthesia of children and adolescents is the patients’ refusal to cooperate with the dentist; this concerns especially the so-called special care patients, and among them, those suffering from epilepsy. Aim. The aim of the study was to evaluate the structure of treatment procedures in conservative dentistry and dental surgery performed under general anaesthesia in children and adolescents with epilepsy. Material and methods. The analysis covered case histories of 109 patients with epilepsy, aged 3-18 years, who received dental treatment under general anaesthesia. The patients were divided into three age groups, according to the dentition type: patients with deciduous dentition - 3-5 years of age; with mixed dentition - 6-12 years, and with permanent dentition - 13-18 years. The analysis concerned the procedures on both deciduous and permanent teeth. Results. An average number of extractions in a child with full deciduous dentition was 3.9 teeth, while in a child with mixed dentition - 2.7 teeth. The greatest number of deciduous teeth extractions concerned first and second molars. Carious cavities in the occlusal surfaces of permanent teeth, due to deep caries, were the most frequently treated lesions. Conclusions. In patients with epilepsy treated under general anaesthesia, extensive treatment needs, resulting from prophylactic and therapeutic neglect in dental care, were found. Conservative and surgical treatment, combined with prophylactic procedures, performed under general anaesthesia seems one of the necessary elements of a complex dental care in uncooperative children and adolescents

scholarly journals Radiological Evaluation of Stainless Steel Crowns Placed on Permanent Teeth in Patients Treated under General Anaesthesia

2021 ◽  
Vol 18 (5) ◽  
pp. 2509
Author(s):  
Marie-Laure Munoz-Sanchez ◽  
Natacha Linas ◽  
Nicolas Decerle ◽  
Valérie Collado ◽  
Denise Faulks ◽  
...  
Keyword(s):  
Stainless Steel ◽  
General Anaesthesia ◽  
Alveolar Bone ◽  
Dental Treatment ◽  
Glass Ionomer Cement ◽  
Permanent Teeth ◽  
Marginal Adaptation ◽  
Permanent Molars ◽  
A Minor ◽  
Ionomer Cement

Evidence-based evaluations of dental treatment are needed to support the development of special care dentistry services. This retrospective study was designed to collect and analyse X-ray images of permanent teeth restored with stainless steel crowns (SSC) in patients treated under general anaesthesia. Between 2013 and 2019, 360 permanent molars were crowned with SSCs in 198 adult patients. One calibrated investigator used an original validated tool to evaluate four radiographic criteria for molars restored with SSCs: i) marginal adaptation; ii) interdental proximal contact; iii) the presence of glass ionomer cement overflow; and iv) the loss of alveolar bone. Overall, no defect or a minor defect was reported for the majority of SSCs for the criteria “Marginal adaptation” (62.5%, n = 320), “Proximal contact” (82.2%, n = 236) and “Cement overflow” (95.8%, n = 337). Alveolar bone resorption was reported in 8.3% of cases, n = 14, after a mean period of 8.9 ± 14.3 months. It was shown that the restoration of permanent teeth using SSCs placed under general anaesthesia presents a low risk of periodontal morbidity in the medium term when assessed radiographically.

Dental care for the bariatric patient

Dental Update ◽  
2021 ◽  
Vol 48 (4) ◽  
pp. 302-306
Author(s):  
Jessica Hamilton ◽  
Mary Gittins ◽  
Andrew Geddis-Regan ◽  
Graham Walton
Keyword(s):  
General Anaesthesia ◽  
Dental Care ◽  
Clinical Relevance ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Careful Consideration ◽  
Equitable Access ◽  
Bariatric Patient ◽  
Access To Dental Care ◽  
Obese Population

As the overweight and obese population increases, one must be mindful of the implications on the delivery of dental care to this group. Appropriate facilities must be available, which may warrant structural and equipment adaptations to clinical and non-clinical areas. The complexity of dental treatment planning and delivery may be compounded by medical comorbidities, and careful consideration must be given to the suitability and safety of conscious sedation and general anaesthesia in order to facilitate treatment. This article aims to discuss how safe provision and equitable access to dental care can be achieved for the bariatric population. CPD/Clinical Relevance: This article aims to discuss the challenges posed by the increase in the overweight and obese population and considerations to be taken for provision of safe and equitable bariatric dental care.

Dental Caries in Children and Adolescents During and After Antineoplastic Chemotherapy

2018 ◽  
Vol 42 (3) ◽  
pp. 225-230
Author(s):  
Dorota Olczak-Kowalczyk ◽  
Ewa Krasuska-Sławińska ◽  
Agnieszka Brożyna ◽  
Anna Turska-Szybka ◽  
Bożenna Dembowska-Bagińska
Keyword(s):  
Children And Adolescents ◽  
Healthy Subjects ◽  
Dental Hygiene ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
White Spot Lesions ◽  
Icdas Ii ◽  
High Incidence ◽  
Antineoplastic Treatment ◽  
Antineoplastic Chemotherapy

Objective: To assess caries incidence, intensity, and treatment in children and adolescents under/after antineoplastic treatment. Study design: Patients with permanent and mixed dentition were divided into three groups of 60 patients each (5–18 years): CH – under chemotherapy; PCH – after chemotherapy; CG – generally healthy subjects. Caries incidence, intensity (DMFT/dmft, DMFS/dmfs), and mean numbers of teeth/surfaces with white spot lesions–WSL (D1+2/d1+2) were assessed following the ICDAS-II criteria. Statistical analysis: Mann-Whitney U test, significance at p≤0.05). Results: Caries incidence was significantly higher in PCH and CH (88.33% and 90%) than in CG (66.66%). Caries intensity was higher in both mixed and permanent dentition in patients under and after chemotherapy. The DMFS/DMFT correlation was the highest in PCH. Treatment indexes for primary and permanent teeth treatment were significantly lower in PCH and CH than CG. Conclusion: Antineoplastic chemotherapy is associated with caries development and its high incidence during/after treatment. As dental hygiene was poor in patients under and after antineoplastic treatment, dental checkups need to be more frequent and thorough.

scholarly journals Acceptability of intravenous propofol sedation for adolescent dental care

2019 ◽  
Vol 21 (3) ◽  
pp. 295-302
Author(s):  
C. Dixon ◽  
A. Aspinall ◽  
S. Rolfe ◽  
C. Stevens
Keyword(s):  
General Anaesthesia ◽  
Thematic Analysis ◽  
Dental Care ◽  
Patient Reported Outcomes ◽  
Dental Treatment ◽  
Anaesthetic Agent ◽  
Patient Acceptability ◽  
Propofol Sedation ◽  
Patient Reported ◽  
Adolescent Patients

Abstract Purpose Propofol is an intravenous anaesthetic agent commonly utilised in general anaesthesia, however in sub-anaesthetic concentrations can be utilised to provide sedation through automated dosing of target-controlled infusion (TCI). TCI has been shown to provide accurate and stable predicted plasma and effect-site concentrations of propofol. A four-part mixed-method prospective study was undertaken to evaluate the safety and patient acceptability of intravenous propofol sedation in adolescent patients requiring dental care. There is a paucity in the literature on patient-reported outcomes and patient safety in the management of adolescent patients for dental treatment. Methods Demographics were recorded including age, gender, ASA Classification and Children’s Fear Survey Schedule—Dental Subscale (CFSS-DS) completed pre-operatively. Behaviour ratings of the Frankl and Houpt scales were recorded followed by post-operative questionnaire and telephone consultation. Consultation was completed following the procedure to determine patient satisfaction, memory of the procedure and any reported side effects of treatment. Qualitative thematic analysis was utilised. Results 55 patients were recruited for the study, of which 49 (mean age 14.67 years) completed the sedation study and were treated safely with no post-operative complications. The mean lowest oxygen saturation was 98.12% SpO2 (SD 2.6). Thematic analysis demonstrated positive patient-reported outcomes to IV sedation. Conclusion Propofol TCI sedation is an effective treatment modality for the management of dentally anxious adolescents as a safe alternative to general anaesthesia, allowing the opportunity for increased provision of treatment per visit on those patients with a high dental need. Further randomised controlled trials comparing propofol TCI to other pharmacological managements are required.

scholarly journals Orthodontic Treatments of Papillon-Lefevre Syndrome: Two Case Reports

2021 ◽  
Vol 30 (02) ◽  
pp. 132-138
Author(s):  
Laila Fawzi Baidas ◽  
Keyword(s):  
Orthodontic Treatment ◽  
Autosomal Recessive ◽  
Case Reports ◽  
Autosomal Recessive Disorder ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Dental Arch ◽  
Facial Appearance ◽  
Deciduous Dentition ◽  
Palmoplantar Hyperkeratosis

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and early onset of severe destructive periodontitis causing premature loss of both deciduous and permanent dentitions at a young age. In this article two cases of patients with Papillon-Lefevre syndrome in late mixed dentition are presented. The objective of these case reports was to illustrate that under a controlled regime of periodontal treatment, orthodontic treatment is possible in patients with Papillon-Lefevre syndrome. In both cases, the deciduous dentition was lost prematurely shortly after eruption. The permanent teeth erupt without any guidance, and this can lead to loss of space, crowding, and collapse of the dental arch. The aim of the treatment was to expand the arch, create space to allow normal eruption of the permanent teeth, and stabilize the occlusion to help the patient achieve a normal facial appearance rather than the collapsed appearance caused by early extractions. KEYWORDS: Papillon-Lefevre Syndrome, Orthodontics, Mixed dentition, Case reports

Too old to sedate: How old is too old?

Dental Update ◽  
2021 ◽  
Vol 48 (2) ◽  
pp. 106-113
Author(s):  
Natalie Bradley
Keyword(s):  
Older People ◽  
General Anaesthesia ◽  
Old Age ◽  
Dental Care ◽  
Clinical Relevance ◽  
Older Patients ◽  
Dental Treatment ◽  
Anxiety Control ◽  
The Uk ◽  
Dental Work

The UK population is ageing with over a quarter of people predicted to be over 65 by 2040. People are retaining their teeth into old age, often having experienced complex restorative dental work over the years. The increasing complexity of dental treatment that older people require will create challenges for those who provide care for this population, including dental treatment under sedation or general anaesthesia. This article discusses the medical, dental and social considerations that need to be taken into account when planning dental care for older patients under sedation or general anaesthesia. CPD/Clinical Relevance: Dentists who provide sedation must be able to appropriately assess and manage their older patients safely if considering this method of pain and anxiety control for dental treatment.

scholarly journals Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 120
Author(s):  
Abbas Jessani ◽  
Mir Faeq Ali Quadri ◽  
Pulane Lefoka ◽  
Abdul El-Rabbany ◽  
Kirsten Hooper ◽  
...  
Keyword(s):  
Public Schools ◽  
Health Status ◽  
Oral Health ◽  
Service Utilization ◽  
Southern Africa ◽  
Dental Care ◽  
Dental Treatment ◽  
Oral Health Status ◽  
Dental Service ◽  
Treatment Needs

This study aimed to characterize the best predictors for unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa. A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate, and multivariate regressions. Five hundred and twenty-six survey responses and examinations were gathered. The mean age of student participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n = 355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous two years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Our results suggest that access to oral health care is limited in Lesotho. Further patient oral health education and regular dental care may make an impact on this population.

scholarly journals Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa

2020 ◽  
Author(s):  
Abbas Jessani ◽  
Faeq Quadri ◽  
Abdul El-Rabbany ◽  
Kirsten Hooper ◽  
Hyun Ja Lim ◽  
...  
Keyword(s):  
Public Schools ◽  
Health Status ◽  
Oral Health ◽  
Service Utilization ◽  
Southern Africa ◽  
Dental Care ◽  
Dental Treatment ◽  
Oral Health Status ◽  
Dental Service ◽  
Treatment Needs

Abstract Objectives: To identify the unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa, and characterize the best predictors for perceived oral health status and dental visits for these adolescents. Method: A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate and multivariate regressions. Results: Five hundred and twenty-six survey responses and examinations were gathered. The mean age of participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n=355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous 2 years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Conclusion: Our results suggest that access to oral health care is limited in Lesotho. Dental decay on molars was prevalent. Further patient oral health education and regular dental care may make an impact on this population.

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