A retrospective study of dental treatment under general anesthesia of children with or without a chronic illness and/or a disability.
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BACKGROUND: The indications for dental treatment under general anesthesia have been described by various authors as extensive decay, behavioral management problems, a medically compromised patient, a handicapped patient, and a combination of these. Few studies have been undertaken to identify the range of treatment provided for chronically sick children. The aim of this study was to identify the characteristics of dental procedures performed under general anesthesia on children with a chronic illness and/or a disability, and compare these findings with other normal children. METHODS: A retrospective, comparative study was designed. Children who received comprehensive dental treatment under general anesthesia at Kaohsiung Chang-Gung Memorial Hospital, Taiwan, in 2002 were enrolled in this study. Patients with a chronic illness and/or a disability were included in group I, and other relatively normal patients were placed in group II. RESULTS: Group I children were significantly older than those of group II (p < 0.0001). Different patterns of dental treatment were noted when the 2 groups were compared. Significantly greater numbers of stainless steel crown build-ups (p = 0.028) and pulpal treatments (p = 0.003) were found among group II patients. There was no significant between-group difference in restorations (p = 0.934); however, group I had a significantly higher (p = 0.006) number of extractions. CONCLUSIONS: By comparing the different patient groups receiving comprehensive dental treatment under general anesthesia, it was found that patients with a chronic illness and/or a disability had a significantly higher average surgical age and fewer pulpal treatments, received fewer stainless steel crowns, and underwent more extractions. Providing early treatment for children with a chronic illness and/or a disability may improve their dental health and maintain full dentition so as to reduce the number of subsequent tooth extractions. Thus, it is highly recommended to refer these children at an earlier age to a hospital where tooth restoration under general anesthesia can be performed. (+info)
Patients with special health care needs in general and pediatric dental practices in Ontario.
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The objective of this study was to determine the involvement of Ontario's general and pediatric dentists in providing care to patients with special health care needs (PSHCNs). A questionnaire was developed and sent to a randomly selected sample of general dentists and to all pediatric dentists in Ontario; response rates were 52% and 90%, respectively. Most general dentists and all pediatric dentists reported that they provided a full range of dental services to PSHCNs. Most (80%) general dentists treat PSHCNs of all ages, whereas 60% of pediatric dentists report only treating PSHCNs up to the age of 18 years. A majority of both groups report treating PSHCNs whose dental care is paid through various government-funded programs. Most general dentists received training in the treatment of PSHCNs in undergraduate dental school, and 40% reported taking continuing education courses in this area. Most pediatric dentists received this training during their advanced dental specialty training, and 29% reported taking continuing education courses in this area. The results of this survey appear to demonstrate that general and pediatric dentists in Ontario provide a full range of dental services to PSHCNs, treat patients with a variety of disabilities and of all ages and are interested in pursuing continuing education that focuses on the delivery of dental care to PSHCNs. However, the results may be inaccurate because of question design flaws and responder bias among the 52% of surveyed general dentists who returned their questionnaires. (+info)
Improving student dentist competencies and perception of difficulty in delivering care to children with developmental disabilities using a virtual patient module.
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An interactive, multimedia, virtual patient module was designed and developed on compact disc (CD-ROM) to address the need for student dentists to increase their competence and decrease their perception of difficulty in caring for children with developmental disabilities. A development team consisting of pediatric dentistry faculty members, parents of children with developmental disabilities, an individual with a developmental disability, and educational specialists developed an interactive virtual patient case. The case involved a ten-year-old child with Down syndrome presenting with a painful tooth. Student dentists were required to make decisions regarding proper interactions with the child, as well as appropriate clinical procedures throughout the case. Differences in perceived difficulty level and knowledge change were measured, as well as the student dentists' overall satisfaction with the learning experience. Significant results were obtained in both perceived difficulty level and knowledge-based measures for student dentists. Participants reported overall satisfaction with the modules. Preparing student dentists to provide sensitive and competent care for children with developmental disabilities is a critical need within dentistry. This study demonstrated that an interactive, multimedia (CD-ROM), virtual patient learning module for student dentists is potentially an effective tool in meeting this need. (+info)
Evaluation of an academic service-learning course on special needs patients for dental hygiene students: a qualitative study.
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The purpose of this study was to evaluate the outcomes of a service-learning course on special needs patients for dental hygiene students by considering student reflections, community site coordinators' feedback, and faculty reflections in a qualitative analysis. Twenty-three female dental hygiene students beginning their fourth semester in the program provided preventive oral health services at eight community sites serving six diverse groups of people having special health care needs. Students reflected on the experience via commentaries written in self-reflection journals. The investigators applied the constant comparative method to analyze and unitize the data, ultimately reaching consensus on three category topics: awareness, higher order thinking, and professionalism. End of course project assessments provided additional data that was used to triangulate with data from the reflective journals. Telephone interviews with the site coordinators and personal interviews with the course faculty provided data from multiple perspectives. The outcomes of this study suggest that service-learning pedagogy can facilitate a deeper understanding of the subject matter and provide an opportunity for students to use critical thinking strategies in addition to becoming aware of complex social and professional issues related to the oral health care of individuals with special needs. (+info)
Students' opinions about treating vulnerable populations immediately after completing community-based clinical experiences.
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The purpose of this study was to analyze students' perceptions of comfort and anticipated willingness to treat selected special needs and traditionally underserved populations immediately upon completion of community-based clinical assignments. The sample consisted of University of Iowa senior dental students who completed a questionnaire that asked, in part, about student comfort with and future willingness to treat twelve vulnerable population groups. With student comfort and future willingness to treat each group as dependent variables, logistic models were developed to determine whether there were significant associations between dependent variables and gender, graduation year, and students' prior experience with these groups. Regression models indicate students' prior experience is most often associated with comfort in treating the associated population group. Likewise, experience and comfort add different dimensions to perceived future willingness to treat almost all of the twelve groups. Student gender, graduation year from dental school, and community assignments influence only a few of these targeted population groups. This study provides empirical evidence concerning students' perceptions about comfort with various vulnerable populations after completing their extramural rotations. Students were more comfortable treating certain population groups as well as more willing to consider including these groups in their future practices. (+info)
Oral health condition and treatment needs of a group of Nigerian individuals with Down syndrome.
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OBJECTIVE: This study was carried out to determine the oral health condition and treatment needs of a group of individuals with Down syndrome in Nigeria. METHOD: Participants were examined for oral hygiene status, dental caries, malocclusion, hypoplasia, missing teeth, crowding and treatment needs. Findings were compared with controls across age group, sex and educational background of parents. RESULT: Participants with Down syndrome had poorer oral hygiene than controls, with no significant sex difference. Oral hygiene was similar in the lower age groups but deteriorated with age in the Down syndrome group. CONCLUSION: Individuals with Down syndrome in Nigeria have poorer oral health and more treatment needs than controls. They would benefit from frequent oral health assessment. (+info)
Dental age in patients with Down syndrome.
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The aim of this research was to evaluate dental age in 102 patients with Down Syndrome, using panoramic radiographs. A software program developed by the Discipline of Radiology, School of Dentistry of Sao Jose dos Campos, Sao Paulo State University (UNESP), was used. A table of mineralization chronology of permanent teeth among Brazilians conceived by Nicodemo, Moraes and Medici Filho was used within the software. Statistical analysis of the results showed that 70.91% of the males and 61.21% of the females presented advanced dental age. Only 32.09% of the males and 38.79% of the females presented delayed dental age. Regarding the differences between the dental and chronological ages, two thirds of the males and females presented dental age with differences of up to 12 months, which means that they can be considered to be within normal standards, whereas only 18.87% of the males and 10.21% of the females presented dental age outside normal standards, with differences of over 24 months. In conclusion, the majority of the patients with Down Syndrome were considered to be within the normal standards of mineralization chronology. (+info)
Survey of special patient care programs at U.S. and Canadian dental schools.
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This article describes the results of a survey of U.S. and Canadian dental schools regarding the delivery of dental care to special needs patients. The purposes of the fifteen-item survey were to identify the percentage of dental schools that operate special patient care (SPC) clinics, gain information as to how care is being provided in those clinics, and identify how this patient population is managed in institutions without designated SPC clinics. Forty percent of the respondent institutions had designated SPC clinics. Institutions without SPC clinics tend to mainstream these patients into their predoctoral clinics or refer them to residency programs such as GPR or pediatric programs within their university. (+info)