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VOLUME 24 , ISSUE 4 ( April, 2023 ) > List of Articles


Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries

Mebin George Mathew, Satish Vishwanathaiah, Yahya Mohsen Khubrani, Masood Ahmed Depsh, Fayez Yahya Almalki

Keywords : Comprehensive dental care, Dental anxiety, Dental fear, Early childhood caries, Full-mouth rehabilitation, General anesthesia, Oral health-related quality of life

Citation Information : Mathew MG, Vishwanathaiah S, Khubrani YM, Depsh MA, Almalki FY. Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries. J Contemp Dent Pract 2023; 24 (4):250-256.

DOI: 10.5005/jp-journals-10024-3500

License: CC BY-NC 4.0

Published Online: 15-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries. Materials and methods: About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up. Results: All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment. Conclusion: Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries. Clinical significance: Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.

  1. Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr 2017;5:157. DOI: 10.3389/fped.2017.00157.
  2. Uribe SE, Innes N, Maldupa I. The global prevalence of early childhood caries: a systematic review with meta-analysis using the WHO diagnostic criteria. Int J Paediatr Dent 2021;31(6):817–830. DOI: 10.1111/ipd.12783.
  3. Tinanoff N, Baez RJ, Diaz Guillory C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: global perspective. Int J Paediatr Dent 2019;29(3):238–248. DOI: 10.1111/ipd.12484.
  4. Mathew MG, Jeevanandan G, Vishwanathaiah S, et al. Parental and child outlook on the impact of ECC on oral health-related quality of life: a prospective interventional study. J Contemp Dent Pract 2022;23(9):877–882. DOI: 10.5005/jp-journals-10024-3397.
  5. Mathew MG, Jeevanandan G, Maganur PC, et al. Evaluation of factors influencing the oral health-related quality of life among children with early childhood caries: a cross-sectional Study. J Contemp Dent Pract 2022;23(9):936–943. DOI: 10.5005/jp-journals-10024-3405.
  6. Rajkumaar J, Mathew MG. Association of severe early childhood caries with salivary ferritin. J Family Med Prim Care 2020;9(8):3991–3993. DOI: 10.4103/jfmpc.jfmpc_9_20.
  7. Schroth RJ, Quiñonez C, Shwart L, et al. Treating early childhood caries under general anesthesia: a national review of Canadian data. J Can Dent Assoc 2016;82:g20. PMID: 27548666.
  8. Schroth RJ, Morey B. Providing timely dental treatment for young children under general anesthesia is a government priority. J Can Dent Assoc 2007;73(3):241–243. PMID: 17439708.
  9. Chouchene F, Masmoudi F, Baaziz A, et al. Parental stress as a predictor of early childhood caries: a systematic review. Eur Arch Paediatr Dent 2021;22(2):111–119. DOI: 10.1007/s40368-020-00580-4.
  10. Pierce A, Singh S, Lee J, et al. The burden of early childhood caries in Canadian children and associated risk factors. Front Public Health 2019;7:328. DOI: 10.3389/fpubh.2019.00328.
  11. Corrêa-Faria P, Viana KA, Raggio DP, et al. Recommended procedures for the management of early childhood caries lesions - a scoping review by the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE). BMC Oral Health 2020;20(1):75. DOI: 10.1186/s12903-020-01067-w.
  12. Murray P, Liddell A, Donohue J. A longitudinal study of the contribution of dental experience to dental anxiety in children between 9 and 12 years of age. J Behav Med 1989;12(3):309–320. DOI: 10.1007/BF00844874.
  13. Grant CG, Daymont C, Rodd C, et al. Oral health-related quality of life of Canadian preschoolers with severe caries after dental rehabilitation under general anesthesia. Pediatr Dent 2019;41(3):221–228. PMID: 31171075.
  14. Cantekin K, Yildirim MD, Cantekin I. Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia. Pediatr Dent 2014;36(1):12E-17E. PMID: 24717700.
  15. Pahel BT, Rozier RG, Slade GD. Parental perceptions of children's oral health: the Early Childhood Oral Health Impact Scale (ECOHIS). Health Qual Life Outcomes 2007;5:6. DOI: 10.1186/1477-7525-5-6.
  16. Ganesh A, Muthu MS, Mohan A, et al. Prevalence of early childhood caries in india - a systematic review. Indian J Pediatr 2019;86(3):276–286. DOI: 10.1007/s12098-018-2793-y.
  17. Zaror C, Matamala-Santander A, Ferrer M, et al. Impact of early childhood caries on oral health-related quality of life: a systematic review and meta-analysis. Int J Dent Hyg 2022;20(1):120–135. DOI: 10.1111/idh.12494.
  18. Schroth RJ, Pierce A, Rodd C, et al. Improvement in iron and iron-related nutritional status following pediatric dental surgery to treat severe early childhood caries. Pediatr Dent 2022;44(1):58–66.
  19. Seow WK. Early childhood caries. Pediatr Clin North Am 2018;65(5):941–954. DOI: 10.1016/j.pcl.2018.05.004.
  20. Knapp R, Marshman Z, Rodd H. Treatment of dental caries under general anaesthetic in children. BDJ Team 2017;4:17116.
  21. Shanbhog R, Godhi BS, Nandlal B, et al. Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India. J Int Oral Health 2013;5(5):1–9. PMID: 24324297.
  22. Clementino MA, Gomes MC, Pinto-Sarmento TC, et al. Perceived impact of dental pain on the quality of life of preschool children and their families. PLoS One 2015;10(6):e0130602. DOI: 10.1371/journal.pone.0130602.
  23. Sardana D, Galland B, Wheeler BJ, et al. Effect of sleep on development of early childhood caries: a systematic review. Eur Arch Paediatr Dent 2023; 24(1):1–14. DOI: 10.1007/s40368-022-00753-3.
  24. Alqaderi H, Tavares M, Hartman M, et al. Effect of sleep and salivary glucose on gingivitis in children. J Dent Res 2016;95(12):1387–1393. DOI: 10.1177/0022034516661509.
  25. Ogawa M, Ogi H, Nakamura D, et al. Association between insufficient sleep and dental caries among preschoolers in Japan: a cross-sectional multicentre study. Eur J Investig Health Psychol Educ 2021;12(1):1–10. DOI: 10.3390/ejihpe12010001.
  26. Zhang Q, Deng X, Wang Y, et al. Postoperative complications in Chinese children following dental general anesthesia: a cross-sectional study. Medicine (Baltimore) 2020;99(45):e23065. DOI: 10.1097/MD.0000000000023065.
  27. Rajab LD, Obaid AE, Hamdan MAM, et al. Postoperative morbidity of dental paediatric patients treated under general anaesthesia at a university hospital: an observational study. Int J Dent 2022;2022:9606010. DOI: 10.1155/2022/9606010.
  28. Atan S, Ashley P, Gilthorpe MS, et al. Morbidity following dental treatment of children under intubation general anaesthesia in a day-stay unit. Int J Paediatr Dent 2004;14(1):9–16. DOI: 10.1111/j.1365-263x.2004.00520.x.
  29. Jiang H, Shen L, Qin D, et al. Effects of dental general anaesthesia treatment on early childhood caries: a prospective cohort study in China. BMJ Open 2019;9(9):e028931. DOI: 10.1136/bmjopen-2019-028931. PMCID: PMC6738709.
  30. Lee VHK, Grant CG, Mittermuller BA, et al. Association between early childhood oral health impact scale (ECOHIS) scores and pediatric dental surgery wait times. BMC Oral Health 2020;20(1):285. DOI: 10.1186/s12903-020-01263-8.
  31. Acs G, Pretzer S, Foley M, et al. Perceived outcomes and parental satisfaction following dental rehabilitation under general anesthesia. Pediatr Dent 2001;23(5):419–423. PMID: 11699167.
  32. El Batawi HY, Panigrahi P, Awad MA. Perceived outcomes and satisfaction of Saudi parents and their children following dental rehabilitation under general anesthesia: a 2-year follow-up. J Int Soc Prev Community Dent 2014;4(Suppl 3):S153–S160. DOI: 10.4103/2231-0762.149024.
  33. El Batawi HY. Factors affecting clinical outcome following treatment of early childhood caries under general anaesthesia: a two-year follow-up. Eur Arch Paediatr Dent 2014;15(3):183–189. DOI: 10.1007/s40368-013-0081-0.
  34. Chhabra N, Chhabra A, Walia G. Prevalence of dental anxiety and fear among five to ten year old children: a behaviour based cross sectional study. Minerva Stomatol 2012;61(3):83–89. PMID: 22402299.
  35. Kruger E, Thomson WM, Poulton R, et al. Dental caries and changes in dental anxiety in late adolescence. Community Dent Oral Epidemiol. 1998;26(5):355–359. DOI: 10.1111/j.1600-0528.1998.tb01973.x.
  36. Milsom KM, Tickle M, Humphris GM, et al. The relationship between anxiety and dental treatment experience in 5-year-old children. Br Dent J 2003;194(9):503–506. DOI: 10.1038/sj.bdj.4810070.
  37. Viswanath D, Krishna AV. Correlation between dental anxiety, Sense of coherence (SOC) and dental caries in school children from Bangalore North: a cross-sectional study. J Indian Soc Pedod Prev Dent 2015;33(1):15–18. DOI: 10.4103/0970-4388.148962.
  38. Abanto J, Vidigal EA, Carvalho TS, et al. Factors for determining dental anxiety in preschool children with severe dental caries. Braz Oral Res 2017;31:e13. DOI: 10.1590/1807-3107BOR-2017.vol31.0013.
  39. Aminabadi NA, Sohrabi A, Erfanparast LK, et al. Can birth order affect temperament, anxiety and behavior in 5 to 7-year-old children in the dental setting? J Contemp Dent Pract 2011;12(4):225–231. DOI: 10.5005/jp-journals-10024-1039.
  40. Erkmen Almaz M, Akbay Oba A, Saroglu Sonmez I. Postoperative morbidity in pediatric patients following dental treatment under general anesthesia. Eur Oral Res 2019;53(3):113–118. DOI: 10.26650/eor.20190023.
  41. Farsi N, Ba'akdah R, Boker A, et al. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia. BMC Oral Health 2009;9:6. DOI: 10.1186/1472-6831-9-6.
  42. Ghafournia M, Eshghi A, Mosleh H, et al. Complications after dental rehabilitation under general anesthesia in Isfahan during February to May 2016. Dent Res J (Isfahan) 2021;18:53. PMID: 34497688.
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