Clinical Pathways in Managing High-Caries Children with Adverse Dental Histories

Area of Science:

• Pediatric Dentistry
• Dental Anesthesia
• Behavioral Management in Dentistry

Background:

• Treating children with prior negative dental experiences poses challenges, often necessitating sedation or general anesthesia.
• Identifying factors influencing treatment pathways for these children is crucial for optimizing care.

Purpose of the Study:

• To determine treatment modalities for pediatric dental patients with adverse dental experiences.
• To identify factors associated with dental treatment under general anesthesia, nitrous oxide sedation, and chairside management.

Main Methods:

• Retrospective cohort analysis of children aged 2-12 years with negative dental experiences and treatment needs.
• Data collected from patients visiting the Pediatric Dental Clinic at the University of Greifswald between January 1 and December 31, 2021.

Main Results:

• Of 78 eligible patients, 25.6% received general anesthesia, 56.4% received nitrous oxide sedation, and 18% underwent chairside treatment.
• Younger age, higher caries severity (dmft/dt scores), and lower behavior ratings were associated with general anesthesia, but not independent predictors.
• Caries was the primary complaint for 88.5% of patients, with 61.5% referred by other dentists.

Conclusions:

• Minimally invasive caries management is key to reducing treatment complexity.
• Appropriate behavior guidance and timely use of conscious sedation can significantly decrease the requirement for general anesthesia.
• These strategies are effective even for children with dental anxiety or a history of negative dental experiences.