Background: Dental disease in children remains a significant cause of morbidity in the UK. In 2013-2014, more than 46,000 children were admitted to hospital for dental treatment under general anaesthetic. Whilst Dental General Anaesthesia (DGA) is a valid treatment option for some children, it is not without risk or significant resource. It is therefore important to establish risk factors that may make a repeat dental general anaesthetic more likely, in order to reduce this risk in future.
Aims: There were two parts of this study with individual aims. 1) Epidemiology study: to determine the prevalence of repeat dental general anaesthesia in children across North Yorkshire from 2002 to 2018. 2) Case Control study: to examine characteristics that are more commonly found in children receiving more than one dental general anaesthetic. These include patient demographics, medical and social history, pre-operative radiographs, and the treatment provided.
Methods: Electronic patient records from North Yorkshire Salaried Dental Services were searched for all patients under the age of 18 whom received DGA between January 2002 and May 2018. This included patients who received repeat DGA episodes. Records were examined to ascertain patient characteristics. These fell into three broad categories, patient demographics (such as age and gender), patient history (such as acute symptoms and medical history) and treatment provided (such as radiographic assessment and number of teeth extracted). For the epidemiology study, all children who received more than one DGA were included. For the Case Control study, all children who received more than one DGA (study group) were included and compared to a control group of children who received a single DGA.
Results: There were 6012 DGA episodes in North Yorkshire over the 16-year time period. 5427 patients received a single DGA. 248 patients received 2 DGAs, 20 patients received 3 DGAs, 6 patients received 4 DGAs and 1 patient received 5 DGAs. There was a total of 275 repeat DGA episodes. Repeat DGA prevalence was 4.8%, with an average interval of 3 years 5 months between DGAs. Age, number of restorations, radiographic assessment, and planned follow-up at the first DGA episode were all associated with increased likelihood of repeat DGA, as was the presence of a neurological disability.
Conclusions: Specific risk factors for repeat DGA have been identified in this population. These risk factors should be taken into consideration when providing routine dental care, oral health advice, and when planning dental treatment under general anaesthetic.
