Research abstract
British Dental Journal 200, 39 - 43 (2006)
Published online: 14 January 2006 | doi:10.1038/sj.bdj.4813123
Subject Category: Paediatric dentistry
Dental anxiety, distress at induction and postoperative morbidity in children undergoing tooth extraction using general anaesthesia
M T Hosey1, L M D Macpherson2, P Adair3, C Tochel4, G Burnside5 & C Pine6
- Dentists are obliged to explain the risks associated with GA dental extractions to parents: this paper will help dentists to warn parents about post-operative morbidity.
- The preparation of children to facilitate coping strategies to enable them to accept anaesthetic induction is important but is less widely available for CDGA patients.
- This paper links dental anxiety to anaesthetic induction distress and so may alert dentists and CDGA service providers to those children who most need preparation eg play therapy pre-CDGA.
Abstract
Objective To report on the prevalence of postoperative morbidity in children undergoing tooth extraction under chair dental general anaesthetic (CDGA) in relation to pre-operative dental anxiety and anaesthetic induction distress.
Design A prospective national study.
Setting Twenty-five Scottish DGA centres in 2001.
Subjects and method Four hundred and seven children (mean age 6.6 years; range: 2.3 to 14.8 years; 52% male). Before CDGA, the Modified Child Dental Anxiety (MCDAS) and Modified Dental Anxiety (MDAS) Scales were completed for children and accompanying adult respectively; the latter also returned a morbidity questionnaire 24 hours and one week post-operatively. Anaesthetic induction distress was scored immediately before CDGA induction using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS).
Results The mean MCDAS score was 24.2 (population norm 18.2); 21% of adults were anxious. Forty-two per cent of children had induction distress; this related to their MCDAS scores (r= 0.43, p<0.001, Pearson Product Moment Correlation Coefficient). Morbidity at 24 hours and seven days was 63% and 24% respectively; this related to MCDAS scores (r= 0.15, p=0.029 and r= 0.17, p= 0.009, Pearson Product Moment Correlation Coefficient) and to induction distress (chi2= 7.14, p= 0.007 and chi2= 11.70, p= 0.001).
Conclusion The majority of children suffered next day morbidity and many still had symptoms a week later. Most children were dentally anxious; this related to induction distress and postoperative morbidity.
- Senior Lecturer/Honorary Consultant in Paediatric Dentistry, University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ
- Senior Lecturer/Honorary Consultant in Dental Public Health, University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ
- Consultant Clinical Psychologist/Honorary Research Fellow (Liverpool Dental Hospital), Department of Clinical Psychology, 4th Floor, Bostock House, The Royal Hospitals, Grosvenor Road, Belfast BT12 6BA
- Health Services Researcher, NHS Quality Improvement Scotland, 50 West Nile Street, Glasgow, G1 2NP
- Clinical Dental Sciences, University of Liverpool
- Professor of Dental Public Health and Primary Dental care, Liverpool University dental Hospital and School of Dentistry, Pembroke Place, Liverpool, L3 5PS
Correspondence to: M T Hosey1 e-mail: m.t.hosey@dental.gla.ac.uk
