FARMAKOLOJİK YÖNTEMLER İLE DENTAL TEDAVİSİ YAPILAN ÇOCUKLARDA TEDAVİ SÜRESİ VE POST-OP ŞİKAYET İLİŞKİSİ

Year 2023, Volume: 32 Issue: Ek Sayı, 30 - 34, 25.12.2023

Kevser Solak Kolcakoglu , Ebru Şenyiğit , Gül Yücel , Esra Kızılcı

https://doi.org/10.34108/eujhs.1344511

Abstract

Çocukluk çağında diş çürükleri uzun yıllardır önemli bir sağlık sorunu olmuştur. Diş çürüğü, karyojenik mikroorganizmalar, fermente olabilen karbonhidratlar ve konakçı duyarlılığı arasındaki etkileşimler nedeniyle ortaya çıkar. Ne yazık ki diş çürüğü kendini sınırlayamaz. Bu nedenle, diş çürüğünün sonuçlarını ele almak için profesyonel müdahale gereklidir. Pediatrik hastalara diş tedavisi sağlamak, özellikle genç yaşları nedeniyle işbirliği yapmayan, olgunlaşmamış veya fiziksel/zihinsel engelleri olan çocuklar için zordur. Bu hastalar farmakolojik teknikler kullanılarak yönetilebilir. Özellikle yüksek çürük riskli hastalarda öncelikle geniş çürük lezyona sahip çocukları tedavi etmek için bu yöntemler sıklıkla kullanılır. Bu çalışmada, genel anestezi ve sedasyon altında tedavi edilen pediatrik hastalarda dental tedavi yaklaşımlarının, dental tedavi sürelerinin hasta şikayetleri ile ilişkisini değerlendirmek amaçlanmıştır. Diş muayeneleri deneyimli pedodontistler tarafından ve tıbbi muayeneleri deneyimli çocuk doktoru tarafından yapılan hastaların verileri elde edilmiştir. Hastalar genel anestezi ve sedasyon, sistemik hastalık varlığı, dental tedavi süresi ve ameliyat sonrası hasta şikayetlerine göre gruplara ayrılmıştır. Çalışmada 0.05’den küçük p değerleri istatistiksel olarak anlamlı kabul edilmiştir. Analizler SPSS 22.0 paket programı ile yapılmıştır. Tedavi süresi ile hasta şikayetleri arasında anlamlı farklılık olduğu görülmüştür. Tedavi süresi arttıkça uyku hali artmıştır (p=0.02). Sistemik hastalığı var olan grubun anestezi sonrası hasta şikayeti gerçekleşme oranlarının anlamlı düzeyde yüksek olduğu tespit edilmiştir (p=0.04). Genel anestezi ve sedasyon altında başarılı diş tedavileri yapılsa dahi, bu yöntemler çürük lezyonlarının gelişimini önlemeye yardımcı olmaz. Çocuk diş hekimlerinin odak noktası, ağız hastalıklarını önlemeye yönelik bir yaklaşım olmalıdır.

Keywords

Çocuk Diş Hekimliği, Genel Anestezi, Sedasyon.

DURATION OF TREATMENT AND RELATIONSHIP WITH POST-OP COMPLAINTS IN CHILDREN WITH DENTAL TREATMENT WITH PHARMACOLOGICAL METHODS

Abstract

Dental caries in childhood has been an important health problem for many years. Dental caries occurs due to interactions between cariogenic microorganisms, fermentable carbohydrates and host susceptibility. Unfortunately, dental caries cannot limit itself. Therefore, professional intervention is necessary to address the consequences of dental caries. Providing dental treatment to pediatric patients is particularly challenging for children who are uncooperative due to their young age, immature, or have physical/mental disabilities. These patients can be managed using pharmacological techniques. These methods are frequently used to primarily treat children with large caries lesions, especially in patients with high caries risk. In this study, it was aimed to evaluate the relationship between dental treatment approaches, dental treatment durations and patient complaints in pediatric patients treated under general anesthesia and sedation. The data of the patients whose dental examinations were performed by experienced pedodontists and medical examinations by experienced pediatricians were obtained. Patients were divided into groups according to general anesthesia and sedation, presence of systemic disease, duration of dental treatment and postoperative patient complaints.In the study, p<0.05 was considered statistically significant. Analyzes were made with the SPSS 22.0 package program. It was observed that there was a significant difference between the duration of treatment and patient complaints. As treatment duration increased, sleepiness increased (p=0.01). It was determined that the rate of patient complaints after anesthesia in the group with the systemic disease was significantly higher (p=0.04). Even if successful dental treatments are performed under general anesthesia and sedation, these methods do not help prevent the development of caries lesions. The focus of pediatric dentists should be on an approach to preventing oral diseases.

Keywords

Pediatric Dentistry, General Anesthesia, Sedation

References

• American Academy on Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Pediatr Dent. 2016;38(6):52-4. PMID: 27931420
• Seow WK. Early Childhood Caries. Pediatr Clin North Am. 2018;65(5):941-954. PMID: 30213355. doi:10.1016/j.pcl.2018.05.004
• American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatr Dent.; 2022:321-39.
• Camilleri A, Roberts G, Ashley P, Scheer B. Analysis of paediatric dental care provided under general anaesthesia and levels of dental disease in two hospitals. Br Dent J. 2004;196(4):219-213. doi:10.1038/sj.bdj.4810988.
• Coté CJ, Wilson S. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures. Pediatr Dent.. 2019;41(4):26e-52e. PMID: 31439094
• Twetman S. Caries risk assessment in children: how accurate are we?. Eur Arch Paediatr Dent. 2016;17(1):27-32. doi:10.1007/s40368-015-0195-7
• Sabbahi DA. Systematic Review of Different Outcomes for Dental Treatment Provided to Children Under General Anesthesia. Ann Dent Spec. 2022;10(1):13-33. doi.org/10.51847/XjoKWslc7T
• Vertullo L, Barrett E, Quinonez C, Sidhu N, Casas M. Trends in repeat general anaesthesia for treatment of dental caries at a children's hospital in Toronto, Canada: a 10-year retrospective investigation. Eur Arch Paediatr Dent. 2021;22(6):1087-1093. doi:10.1007/s40368-021-00667-6
• McAuliffe U, Kinirons M, Woods N, Harding M. A retrospective investigation of the oral health records of a cohort of preschool children who received extractions under general anaesthesia including cost analysis of treatment. J Ir Dent Assoc. 2017;63(1):38-44. PMID: 29797846
• Zhang Q, Deng X, Wang Y, Huang R, Yang R, Zou J. Postoperative complications in Chinese children following dental general anesthesia: A cross-sectional study. Medicine (Baltimore). 2020;99(45):e23065. doi:10.1097/MD.0000000000023065
• World Health Organization. Oral health surveys: basic methods:5ed.; 2013.p.47
• Baghdadi ZD. Effects of dental rehabilitation under general anesthesia on children's oral health-related quality of life using proxy short versions of OHRQoL instruments. ScientificWorldJournal. 2014;2014:308439. doi:10.1155/2014/308439
• Sabbahi DA. Systematic Review of Different Outcomes for Dental Treatment Provided to Children Under General Anesthesia. Ann Dent Spec. 2022;10:13-33.doi.org/10.51847/xjokwslc7t
• Mortazavi H, Baharvand M, Safi Y. Death Rate of Dental Anaesthesia. J Clin Diagn Res. 2017;11(6):ZE07-ZE09. doi:10.7860/JCDR/2017/24813.10009
• Roberts GJ, Mokhtar SM, Lucas VS, Mason C. Deaths associated with GA for dentistry 1948 - 2016: the evolution of a policy for general anaesthesia (GA) for dental treatment. Heliyon. 2020;6(1):e02671.doi.org/10.1016/j.heliyon.2019.e02671
• Smith WD. A history of nitrous oxide and oxygen anaesthesia IVE: Henry Hill Hickman in his time. Br J Anaesth. 1978;50(8):853-861. doi:10.1093/bja/50.8.853
• Kries T, Rupf S, Hannig M, Naim J, Gund MP. The impact of general medical health status, demographical, and patient-specific variables on need for dental treatment of children and adolescents under general anesthesia. Clin Oral Investig. 2023;27(8):4245-4257. doi:10.1007/s00784-023-05041-y
• Ghafournia M, Eshghi A, Mosleh H, Iranmanesh P. Complications after dental rehabilitation under general anesthesia in Isfahan during February to May 2016. Dent Res J (Isfahan). 2021;18:53.doi.org/10.4103/1735-3327.321864
• Needleman HL, Harpavat S, Wu S, Allred EN, Berde C. Postoperative pain and other sequelae of dental rehabilitations performed on children under general anesthesia. Pediatr Dent. 2008;30(2):111-21. PMID: 18481575
• Farsi N, Ba'akdah R, Boker A, Almushayt A. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia. BMC oral health. 2009;9:6.doi.org/10.1186/1472-6831-9-6
• Akpinar H. Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study. J Dent Anesth Pain Med. 2019;19(4):191-9.
• Kakaounaki E, Tahmassebi JF, Fayle SA. Further dental treatment needs of children receiving exodontia under general anaesthesia at a teaching hospital in the UK. Int J Paediatr Dent. 2006;16(4):263-9. doi:10.1111/j.1365-263X.2006.00747.x
• Tahmassebi JF, Achol LT, Fayle SA. Analysis of dental care of children receiving comprehensive care under general anaesthesia at a teaching hospital in England. Eur Arch Paediatr Dent. 2014;15(5):353-360. doi:10.1007/s40368-014-0123-2
• Berkowitz RJ, Moss M, Billings RJ, Weinstein P. Clinical outcomes for nursing caries treated using general anesthesia. ASDC J Dent Child. 1997;64(3):210-228. PMID: 9262804
• Foster T, Perinpanayagam H, Pfaffenbach A, Certo M. Recurrence of early childhood caries after comprehensive treatment with general anesthesia and follow-up. J Dent Child (Chic). 2006;73(1):25-30. PMID: 16734310
• Amin MS, Bedard D, Gamble J. Early childhood caries: recurrence after comprehensive dental treatment under general anaesthesia. Eur Arch Paediatr Dent. 2010;11(6):269-273. doi:10.1007/BF03262761
• Oubenyahya H, Bouhabba N. General anesthesia in the management of early childhood caries: an overview. J Dent Anesth Pain Med. 2019;19(6):313-322. doi:10.17245/jdapm.2019.19.6.313