Participation of paediatric patients in primary dental care before and after a dental general anaesthetic

Abstract

Purpose: The aim of this retrospective study is to determine children’s attendance andexperience of preventative interventions and operative treatment (restorations andextractions) with their primary care dentist (PCD) in the 12 months before and aftertheir caries management under dental general anaesthetic (DGA). Methods: A record of all children who had an elective DGA in 2016 across two hospital sites wasretrospectively obtained (n = 1308). A representative sample of 300 was randomlyselected encompassing 114 dental practices. An online questionnaire to the children’sPCDs collated quantitative and qualitative data regarding participation in the pre- andpost-DGA period. Results: Data was collated and analysed for 80 children (mean age: 6 years 10 months[SD = 2.49; range: 2 years 1 month – 14 years 3 months]; equal sex distribution) with 43responding PCDs. Attendance for examination declined significantly from 85% (n = 68)pre-DGA to 57.5% (n = 46) post-DGA (p ≤ 0.001). Attendance at emergencyappointments pre-DGA was high (33.75% [n = 27]); a significant reduction post-DGAwas recorded (p ≤ 0.001). Over one third of children (37.5% [n = 30]) did not receiveany form of preventative intervention over 24 months. A non-significant reduction in theprovision of operative treatment was observed post-DGA (p = 0.06 [fill, primary]; p = 0.78[fill, permanent]; p = 0.66 [ext, primary]). No statistical difference between age andtreatment experience was found. Qualitative analysis revealed challenges in providingcare included behavioural difficulties and poor attendance. Conclusion: Improvements are required in strategies employed to support high caries risk childrenpre- and post-DGA to facilitate a higher incidence of attendance and preventativeintervention with PCDs.