General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.
Adult* ; Anesthesia ; Anesthesia, General* ; Anxiety ; Child ; Dental Anxiety ; Dental Care for Chronically Ill ; Dental Care for Disabled ; Humans ; Informed Consent ; Methods ; Surgeons

ABSTRACT This retrospective study aimed to evaluate patterns of comprehensive dental treatment under general anaesthesia (GA) for healthy children in Universiti Teknologi MARA, Malaysia. The treatment records of healthy paediatric patients who received dental treatment under GA from February 2017 to January 2021 were reviewed. The patients were divided into two groups: (1) less than 6 years old and (2) 6 to 16 years old. Patients’ characteristics were summarised using descriptive statistics while an independent t-test was applied to investigate the influence of “age group” on treatment duration, number of procedures and use of various restorative materials. A total of 125 paediatric patients (67 boys and 58 girls) were included. The patients’ mean age at the time they underwent GA was 5.77 ± 1.94 years old and the average duration of dental treatment was 62.58 minutes. There was a significant difference in the duration of treatment between the two age groups (p < 0.05). Tooth extraction was the most dental procedure performed (63.31%). The 6 to 16 years old group had a significantly shorter treatment duration (p < 0.05). However, no significant differences were found in all procedures (extraction, restoration, preventive and pulp therapy) and the utilisation of composite, glass ionomer cement (GIC) and compomer in both groups. The use of stainless steel crown (SSC) restorations was significantly higher in the less than six years old group (p < 0.05). Most of the dental procedures performed under GA on healthy children were extraction procedures. Children less than six years of old had a longer treatment duration under GA. Composite restorations and SSC were more frequently used in primary dentition.
Pediatric Dentistry ; Dental Care for Children ; Anesthesia, Dental

960 pupils between 6 and 12 years old in An Giang province were divided into 4 groups and received different interventions such as fluoride rinse, teeth brushing + ddF rinse, ddF rinse + welding with GIC, and ddF rinse + teeth brushing + welding. These interventions were very effective in protection periodental diseases. Prevalence of good dental health pupils increased significantly. This is a condition to gain WHO’s goals at least 80% primary and secondary pupils receive long-term and stable oral healthcare through school-based dental program in 2010.
Dental Care for Children ; Periodontitis/prevention & control ; Pupil

Children with an intellectual disability often demonstrate lack of cooperation during dental treatment and require behavioral management. A child with mild intellectual disability can be managed adequately using restraints and medication. However, in cases of profound intellectual disability, dental treatment under general anesthesia is usually required. In cases where the patient is an intellectually disabled child who has intellectually disabled parents, it is difficult to evaluate the patient's preoperative condition and to obtain consent for treatment under general anesthesia. Furthermore, they are unable to respond to emergencies after treatment. Therefore, dental treatment should be performed under general anesthesia with hospitalization for children with an intellectual disability. This case presents the dental treatment of an intellectually disabled child, who has intellectually disabled parents, and who required general anesthesia and hospitalization.
Anesthesia, General* ; Child ; Dental Care for Disabled ; Disabled Children* ; Emergencies ; Hospitalization ; Humans ; Intellectual Disability ; Parents*

ABSTRACT The first dental examination is a major step that is affected by many factors and determines the dental treatment process. The main objective of this study was to evaluate the association of child temperament with child dental anxiety, parental dental anxiety, dental behaviour and dental caries. The study consisted of 100 children aged 3 to 6 who were attending their first dental examination and their accompanying parents. The Facial Image Scale (FIS), Frankl’s Behaviour Scale (FBS), Corah’s Dental Anxiety Scale (CDAS) and the Short Temperament Scale for Children (STSC) were used for assessment. The DMFT (decayed, missing and filled teeth) score of each child was recorded. Children who exhibited negative behaviour on the FBS had the highest rhythmicity scores (p = 0.008). The mean DMFT score of children in the rhythmicity temperamental dimension was relatively high (p = 0.008). The parents of children defined as negative on the FBS had high dental anxiety levels on CDAS (p < 0.001). Children whose parents had higher dental anxiety levels showed higher dental anxiety (p = 0.007). The success rate of dental treatment procedures may be increased by improving dentists’ knowledge of dental anxiety related to the child’s temperament and integrating parental support to reduce dental anxiety.
Dental Care for Children ; Dental Anxiety ; Cognitive Behavioral Therapy ; Temperament ; Dental Caries

ABSTRACT This study aimed to determine the fluoride and pH levels of beverages likely to be consumed by children in Malaysia and to estimate daily fluoride intake from consumption of these beverages. A convenience sampling of 120 ready-to-drink beverages were purchased and categorised into 11 groups (UHT recombined milk, fresh milk [pasteurised], cultured milk [probiotic], yogurt beverages, fresh fruit juices, fruit flavoured beverages, soy-based beverages, malt-based beverages, tea, carbonated beverages and bottled waters). Fluoride concentration was measured using a fluoride ion-selective electrode while the pH level was measured using a pH meter. The fluoride concentration in the beverages ranged from 0.02±0.00 mg/L to 2.77±0.06 mg/L. Tea was found to have the highest fluoride concentration. The intake of fluoride from consumption of other types of beverages is below the lowest-observed-adverse-effect level (except tea). The pH of the beverages included in the study ranged from 2.20±0.01 to 7.76±0.00. Carbonated beverages (mean pH: 2.98±0.50) were found to be extremely acidic followed by fresh fruit juices (mean pH: 3.38±0.34) and fruit flavoured beverages (mean pH: 3.90±0.92). The correlation between fluoride and pH levels was weak, τ = 0.058 and not statistically significant (p < 0.35). The majority of the beverages had a low fluoride level and their consumption is unlikely to cause fluorosis except for tea. Almost half of the beverages had a low pH level with carbonated beverages being the most acidic.
Fluoridation ; Carbonated Beverages ; Dental Care for Children ; Acid-Base Imbalance

OBJECTIVE: To retrospectively figure out the oral health status, treatment and follow-ups after dental treatment under general anesthesia (DGA) of disabled children or adolescents. METHODS: Clinical data of disabled children or adolescents and normal children as control received DGA in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology from August 2008 to September 2015 were recorded, including: gender, birth date, treatment date, disability type, oral health status before treatment, treatment content and follow-ups (in 1 year). Differences among ages and disabilities were analyzed statistically. RESULTS: Sixty-two disabled patients and fifty-seven controls were recruited, mean aged (9.38±5.22) years and (3.00±1.41) years. Most patients had 10 to 15 problem teeth with which the mean number of the disabled children and adolescents was (11.79±4.98) while that of the normal controls was (12.40±4.11). Caries, pulpitis, periapical periodontitis, dental trauma and developmental tooth anomalies of the disabled patients accounted for 67.56%, 13.54%, 15.15%, 1.07%, and 2.68%, respectively and the DMFT/dmft index was 11.55±5.56 while in the control group those were at 65.35%,19.09%,14.14%,0,1.41% and 12.23±4.42. The DMFT/dmft index of the disabled patients in the group 6-12 years (8.35±4.69) was significantly less than that of the other three groups (P<0.01) while no differences were found in disabilities (P=0.239). Resin restoration, pit and fissure sealant, preventive resin restoration, pulpotomy, pulpectomy/RCT, extraction and crown of the disabled patients were performed as 52.71%, 7.24%, 8.56%, 0.72%, 17.13%, 10.01% and 3.62% respectively whereas those made up as 56.31%, 1.27%, 0.13%, 2.29%, 19.87%, 7.90% and 12.23% in the control group. Thirty-five (56.45%) disabled patients and forty-three (75.44%) controls recalled. Problem teeth within one year after operation in diabled patients and controls were both nearly twice as much as the number within half a year. Restoration loss/fractured mainly occurred in anterior primary teeth while secondary/ recurrent caries and pulpitis/perapical periodontitis mostly occurred in primary molars. CONCLUSION Oral health status in our disabled children and adolescents is poor. Though dental treatment under GA is an effective way to improve the oral health of disabled children and adolescents, periodic follow-ups and family oral health care are equal important for oral health maintenance.
Adolescent ; Anesthesia, Dental ; Anesthesia, General ; Child ; Child, Preschool ; Dental Care ; Dental Caries ; Dental Restoration Repair/methods* ; Disabled Children ; Female ; Humans ; Male ; Molar ; Pediatric Dentistry ; Pit and Fissure Sealants ; Pulpitis ; Retrospective Studies ; Tooth, Deciduous

Clinical evaluation for a successful root canal treatment is assessed by various criteria, which are clinical, histopathological, and radiographical criteria. Therefore, failure of endodontic treatment can be described as a recurrence of clinical symptoms, with the presence of a periapical radiolucency or both. Failure factors in the treatment are frequently related to persistent infection. Conventional endodontic retreatment is indicated for symptomatic previously treated teeth or asymptomatic teeth with inadequately done initial endodontic treatment to avoid potential recurrence. Endodontic retreatment in elderly patients is a great challenge because the clinician has to reassure both the physical and psychological factors of the patient to determine whether to save a tooth or perform an extraction. Some difficulties may also be found in root canal retreatment, including finding the root canal hole or root canal blockage found in parts of the root canal that have not been repaired in the previous treatment. A 60-year-old female patient came with the chief complaint of recurrent pain, and subjective discomfort in the maxillary left central incisor. The patient had anxiety about the dental treatment. The tooth had a history of root canal treatment four months ago. The clinical examination showed a positive response to the percussion test. The radiographical analysis showed a root canal underfilling, 2-3 mm short of length from the apex. The tooth was diagnosed as a previously treated tooth with symptomatic apical periodontitis. Endodontic retreatment was performed based on the patient’s clinical condition and consent, followed by composite restoration. The clinical and radiographic re-evaluation after four weeks of follow-up revealed an excellent condition. This favorable result showed that a conventional retreatment plan of persistent pain on the previously treated tooth in an elderly patient led to progressive healing, and a longer follow-up was advised.
Dental Care ; Retreatment ; Aged

OBJECTIVEThe purpose of this survey was to assess dental knowledge and behaviors of the teachers and mothers of school children.

METHODSAll data was collected from 1365 mothers of first grade students and 215 schoolteachers in Yichang, Hubei by using questionnaires and, analyzed using SPSS software.

RESULTSThe level of dental knowledge was higher among schoolteachers than among mothers; the mothers were mostly informed through television/book (62.4%/51.5%), while teachers received information from various sources, including the dentists (75.3%). Most of the children (94.0%) didn't have practical support from their parents in daily tooth cleaning. Only 18.9% of them visited the dentist at least once per year.

CONCLUSIONThis finding suggested that we should emphasize oral healthy education among mothers and schoolteachers, in order to promote school-based oral health education program.

Adult ; Attitude to Health ; Child ; China ; Dental Care for Children ; statistics & numerical data ; Dental Caries ; prevention & control ; Female ; Health Behavior ; Health Education, Dental ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Mothers ; Periodontal Diseases ; prevention & control ; Surveys and Questionnaires ; Teaching ; Toothbrushing ; statistics & numerical data

OBJECTIVETo establish the Chinese version of the modified children's fear survey schedule-dental subscale (CFSS-DS).

METHODSThe original English version of CFSS-DS with facial image scale (FIS) was translated into Chinese, pre-tested and cross-culturally adapted. Subsequently the Chinese version schedule was randomly investigated among 367 children aged 5 - 12 years and their parents. Reliability and validity of the translated scale was evaluated later.

RESULTSTotally 367 children were investigated and 311 valid questionnaire was received. Cronbach's alpha of the translated scale was 0.85 and test-rest reliability was 0.73. The 15 items were divided into four domains. There was a certain logical relationship between the items among the same domains. There was highly significant association between the self-report of the Modified CFSS-DS and Frankl Behavioral Scale (r(s) = -0.403, P < 0.01).

CONCLUSIONSThe Chinese version of modified CFSS-DS has been established successfully with good psychometric properties which provide the theoretical evidence for further application in Chinese population.

Child ; Child Behavior ; psychology ; Child, Preschool ; China ; Dental Anxiety ; psychology ; Dental Care for Children ; psychology ; Facial Expression ; Fear ; psychology ; Female ; Humans ; Language ; Male ; Manifest Anxiety Scale ; Pediatric Dentistry ; Self-Assessment ; Surveys and Questionnaires ; Translating