Master of Science in Dentistry
Purpose: To evaluate the treatment of healthy children who are high caries risk and of low socioeconomic status and who require repeat full mouth dental rehabilitation (FMDR) under general anesthesia (GA).
Methods: A retrospective chart review was performed on healthy Medicaid eligible patients who were initially between 18 months - 6 years of age who underwent FMDR under GA in the OR more than once at the Virginia Commonwealth University (VCU) School of Dentistry, Department of Pediatric Dentistry from January 2008 to December 2018. Biographical information for each patient was gathered into a REDCap™ Survey. Statistical analysis, chi-squared test with a significance level set at 0.05, was performed to determine the age, proximity to dental care, level of oral hygiene and preventive services, patient symptoms and treatment rendered during the first OR visit as compared to that rendered at the second OR visit.
Results: A total of 46 subjects were included in the analysis. The majority of patients were referred for GA treatment from an outside provider (n=28, 61%). The median age of patients at the first GA was 29 months and 55.5 months at the second GA. There was a median of 1.6 years between the two GA appointments. The treatment success rate for treatments ranged from 25% for one surface composites to 94% for SSCs. Of the 125 teeth that received an SSC at GA 1, only five required additional treatment and three were extracted at the second GA. 75% of teeth that received a sealant at the first GA needed to be treated at the second GA.
Conclusion: Results indicated differences in treatment planning strategies among pediatric dentists and suggested more aggressive treatment plans were more appropriate for patients who required advanced behavior guidance to prevent frequent GA exposure.
© LaJoi E. Wiggins, DMD
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