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

In recent years, dental treatments of the outpatient children under general anesthesia has gradually developed as a relatively mature behavior management model. Due to the limited operating time and the large patient flow of children in outpatient clinics, higher requirements of management are proposed both in anesthesia and dental treatment phases. The Society of Sedation and Analgesia of the Chinese Stomatological Association organized experts to formulate a guideline of dental treatments of children under general anesthesia in outpatient clinic. The guideline would provide operable implementing criteria for the entire process including general anesthesia in the dental clinics, basic clinical conditions, types of oral diagnosis and treatment, evaluation and preparation before diagnosis and treatment, anesthesia implementation and monitoring, management during the recovery period, common complications and key points of treatments. This guideline will play an important role in the rapid development of the safe and comfort dental treatments of children under general anesthesia in China.
Anesthesia, Dental ; Anesthesia, General ; Child ; China ; Conscious Sedation ; Humans ; Pediatric Dentistry

Caries of children under 3 years old has such characteristics as early onset, multiple tooth involvement and rapid development. It may affect the mastication and digestive functions of the children, as well as oral and systemic development, and may become a risk factor for systemic diseases. In order to standardize the prevention and treatment of the caries of the infants and toddlers, to fully utilize the existing medical resources to prevent caries, to reduce the incidence rate and to increase the treatment rate, and to improve the oral health statuses of the infants and toddlers in China, the Society of Pediatric Dentistry and the Society of Preventive Dentistry of the Chinese Stomatological Association convened experts of pediatric dentistry and preventive dentistry from 19 universities and hospitals to conduct profound discussions on this topic, and finally developed the present guideline on diagnosis, prevention, clinical practice and effect evaluation for caries of children under 3 years old suitable to China's conditions.
Child, Preschool ; China ; Dental Caries/prevention & control* ; Dental Caries Susceptibility ; Humans ; Infant ; Pediatric Dentistry ; Preventive Dentistry

BACKGROUND: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. METHODS: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. RESULTS: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. CONCLUSION: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.
Anxiety ; Behavior Rating Scale ; Behavior Therapy ; Child ; Compliance ; Dental Anxiety ; Dental Equipment ; Dentists ; Heart Rate ; Humans ; Leg ; Methods ; Pediatric Dentistry ; Sensation ; Smartphone ; Weights and Measures

BACKGROUND: Dental anxiety in children is a major barrier in patient management. If dental anxiety in pediatric patients is assessed during the first visit, it will not only aid in management but also help to identify patients who are in need of special care to deal with their fear. Nowadays, children and adults are highly interested in multimedia and are closely associated with them. Children usually prefer motion pictures on electronic devices than still cartoons on paper. Therefore, this study was conducted to evaluate a newly designed scale, the animated emoji scale (AES), which uses motion emoticons/animojis to assess dental anxiety in children during their first dental visit, and compare it with the Venham picture test (VPT) and facial image scale (FIS). METHODS: The study included 102 healthy children aged 4–14 years, whose dental anxiety was measured using AES, VPT, and FIS during their first dental visit, and their scale preference was recorded. RESULTS: The mean anxiety scores measured using AES, FIS, and VPT, represented as mean ± SD, were 1.78 ± 1.19, 1.93 ± 1.23, and 1.51 ± 1.84, respectively. There was significant difference in the mean anxiety scores between the three scales (Friedman test, P < 0.001). The Pearson's correlation test showed a very strong correlation (0.73) between AES and VPT, and a strong correlation between AES and FIS (0.88), and FIS and VPT (0.69), indicating good validity of AES. Maximum number of children (74.5%) preferred AES. CONCLUSION: The findings of this study suggest that the AES is a novel and child-friendly tool for assessing dental anxiety in children.
Adult ; Anxiety ; Child ; Dental Anxiety ; Humans ; Motion Pictures as Topic ; Multimedia ; Pediatric Dentistry ; Weights and Measures

Post-endodontic restorations are both important and challenging for clinical success in endodontically treated posterior teeth. Several options have been proposed to restore endodontically treated molars.In pediatric dentistry, restoration using conventional single crowns, especially for partially erupted molars with insufficient retentive tooth structure, has proven to be difficult. However, the endocrown presents a conservative and esthetic restorative alternative to conventional crowns with post-and-core, as it acquires additional retention within the pulp chamber. The tooth preparation consists of a circular, equigingival, butt-joint margin and a central retention cavity in the pulp chamber that helps to construct both the crown and core as a single unit.This case report describes the esthetic and conservative endocrown restorations of erupting permanent first molars with extensive coronal destruction.
Crowns ; Dental Pulp Cavity ; Molar ; Pediatric Dentistry ; Tooth ; Tooth Preparation

The purpose of this study was to analyze the dental consultation of pediatric inpatients to the department of pediatric dentistry in Yonsei University Severance Hospital, and to investigate the change in patterns. In 2017, 268 pediatric patients (384 cases) admitted to the Severance Hospital were referred to the department of pediatric dentistry. The mean age was 6.6 years, and most of the patients were referred from the Department of Pediatric Hematology Oncology and Rehabilitation Medicine. The chief complaints were as follows: oral examination (31%), dental caries (20%), oral pain (10%), tooth mobility (10%), pre-operative evaluation (9%) and others (20%). 41% of the patients received only oral examination without treatment. Dental caries were the most frequent dental diagnosis of the patients. 28% (111 cases) of patients received operative treatments, 22 cases were treated under general anesthesia. Oral health is closely related to systemic diseases, especially for hospitalized patients. Dental consultations should be encouraged for prevention and early appropriate treatments. For this purpose, it is necessary to establish a referral system and perform dental treatment under general anesthesia.
Anesthesia, General ; Dental Caries ; Diagnosis ; Diagnosis, Oral ; Hematology ; Humans ; Inpatients ; Oral Health ; Pediatric Dentistry ; Referral and Consultation ; Rehabilitation ; Tooth Mobility

The purpose of this study is to analyze the changes in patient distribution and practice pattern resulted from changes of socioeconomic circumstances. From January 2008 to December 2017, information about patient distribution and practice pattern was collected and reviewed.Both the number of new patients and revisiting patients increased. The average age of new patients showed a declining trend. Children aged between 0 and 6 had the majority. In case of restorative treatment, the use of composite resin decreased, whereas resin modified glass ionomer increased. As to pulp treatment of primary tooth, the proportion of pulpectomy increased significantly, but decreased in pulpotomy. The results showed an increase in the treatments under sedation and general anesthesia and with the use of midazolam and nitric oxide increased after 2014.
Anesthesia, General ; Child ; Glass ; Humans ; Midazolam ; Nitric Oxide ; Pediatric Dentistry ; Pulpectomy ; Pulpotomy ; Tooth, Deciduous

The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018.Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2(nd) referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2(nd) referral was relatively delayed with increased ratio of ‘during treatment’.These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.
Child ; Dental Clinics ; Dentists ; Electronic Health Records ; Female ; Humans ; Intellectual Disability ; Jeollabuk-do ; Minor Surgical Procedures ; Outpatients ; Pediatric Dentistry ; Referral and Consultation

BACKGROUND: The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6–11-year-old children during local anesthesia administration. METHODS: The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6–8 years while group 2 consisted of 15 children aged 9–11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. RESULTS: The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. CONCLUSIONS: The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.
Anesthesia ; Anesthesia, Local ; Anxiety ; Child ; Clinical Study ; Heart Rate ; Humans ; Leg ; Methods ; Needles ; Pediatric Dentistry ; Syringes