TREATING EARLY CHILDHOOD CARIES UNDER GENERAL ANESTHESIA: A NATIONAL REVIEW OF CANADIAN DATA.

INTRODUCTION Many Canadian children are affected by early childhood caries (ECC) and require treatment under general anesthesia. The purpose of this study was to determine the burden of day surgery for children with ECC in Canada. METHODS Day surgery abstracts for children 6 years of age with ECC were extracted from the Canadian Institute for Health Information Discharge Abstract Database and National Ambulatory Care Reporting System for 4 years, 2010/11 to 2013/14. All provinces and territories participated except Quebec. Variables considered included sex, age, proportion of immigrants in the neighbourhood, Aboriginal concentration, material deprivation index and rurality. Rates were calculated for the pooled 4-year cohort. RESULTS The overall rate of dental surgery to treat ECC was 12.1 per 1000 children 12-59 months of age, accounting for 31.0% of all day surgeries performed on this age group in Canada. Rates of dental surgery for children from neighbourhoods with a high proportion of Aboriginal people were 7.8 times those for children living in areas with a low proportion (84.5 vs. 10.9 per 1000). For children from rural regions of Canada, rates were 3.2 times those of urban dwelling children (31.2 vs. 9.8 per 1000). Children from the least-affluent regions had dental surgery rates 3.7 times higher than those from the most-affluent communities (25.7 vs. 6.9 per 1000). Total hospital-associated costs of treating ECC under general anesthesia averaged $21184545 annually. CONCLUSION Dental surgery for ECC is far too common and occurs more often among children from the least-affluent households, rural regions and communities with a high proportion of Aboriginal people. Dental surgery rates can serve as an important population health indicator.

[1]  M. Moffatt,et al.  Parents' and caregivers' perspectives on the Manitoba Dental Association's Free First Visit program. , 2016, Journal of public health dentistry.

[2]  R. Schroth,et al.  WHAT ARE CANADIAN DENTAL PROFESSIONAL STUDENTS TAUGHT ABOUT INFANT, TODDLER AND PRENATAL ORAL HEALTH. , 2015, Journal.

[3]  M. Moffatt,et al.  DENTISTS' PERSPECTIVES ON THE MANITOBA DENTAL ASSOCIATION'S FREE FIRST VISIT PROGRAM. , 2015, Journal.

[4]  R. Schroth,et al.  Tracking early visits to the dentist: a look at the first 3 years of the Manitoba Dental Association’s Free First Visit program. , 2015, Journal.

[5]  A. Segura,et al.  Maintaining and Improving the Oral Health of Young Children , 2014, Pediatrics.

[6]  R. Kubilius,et al.  Oral health-related quality of life after dental general anaesthesia treatment among children: a follow-up study , 2014, BMC Oral Health.

[7]  Y. Chen,et al.  Factors Associated With Dental Care Utilization in Early Childhood , 2014, Pediatrics.

[8]  M. Brownell,et al.  Trends in pediatric dental surgery for severe early childhood caries in Manitoba, Canada. , 2014, Journal.

[9]  JoAnna M Scott,et al.  Do early dental visits reduce treatment and treatment costs for children? , 2014, Pediatric dentistry.

[10]  Maryam Amin,et al.  Parental Awareness and Dental Attendance of Children Among African Immigrants , 2015, Journal of Immigrant and Minority Health.

[11]  H. Y. Batawi Factors affecting clinical outcome following treatment of early childhood caries under general anaesthesia: a two-year follow-up , 2013 .

[12]  R. Schroth,et al.  Prevalence and risk factors of caregiver reported Severe Early Childhood Caries in Manitoba First Nations children: results from the RHS Phase 2 (2008–2010) , 2013, International journal of circumpolar health.

[13]  M. Moffatt,et al.  Dentist's views on a province-wide campaign promoting early dental visits for young children. , 2013, Journal.

[14]  W. Thomson,et al.  Changes in young children's OHRQoL after dental treatment under general anaesthesia. , 2012, International journal of paediatric dentistry.

[15]  M. Moss,et al.  Early childhood caries-related visits to emergency departments and ambulatory surgery facilities and associated charges in New York state. , 2012, Journal of the American Dental Association.

[16]  R. Schroth,et al.  Early childhood caries in Indigenous communities: A joint statement with the American Academy of Pediatrics. , 2011, Paediatrics & child health.

[17]  First Nations,et al.  Early Childhood Caries in Indigenous Communities , 2011, Pediatrics.

[18]  Dental caries in rural Alaska Native children--Alaska, 2008. , 2011, MMWR. Morbidity and mortality weekly report.

[19]  E. Kruger,et al.  Trends in demand for general anaesthetic care for paediatric caries in Western Australia: geographic and socio-economic modelling of service utilisation. , 2010, International dental journal.

[20]  M. Moffatt,et al.  Oral health of indigenous children and the influence of early childhood caries on childhood health and well-being. , 2009, Pediatric clinics of North America.

[21]  D. Battistutta,et al.  Case-Control Study of Early Childhood Caries in Australia , 2009, Caries Research.

[22]  D. Locker,et al.  Early childhood caries and access to dental care among children of Portuguese-speaking immigrants in the city of Toronto. , 2008, Journal.

[23]  S. Fayle UK National Clinical Guidelines in Paediatric Dentistry , 2008 .

[24]  R. Schroth,et al.  A review of repeat general anesthesia for pediatric dental surgery in Alberta, Canada. , 2007, Pediatric dentistry.

[25]  Matthew D. Bramlett,et al.  Influences on Children's Oral Health: A Conceptual Model , 2007, Pediatrics.

[26]  R. Schroth,et al.  Providing timely dental treatment for young children under general anesthesia is a government priority. , 2007, Journal.

[27]  K. Roberts-Thomson,et al.  Indigenous and Non-Indigenous Child Oral Health in Three Australian States and Territories , 2007, Ethnicity & health.

[28]  R. Harrison,et al.  Change in parental oral health practices following a child’s dental treatment under general anaesthesia , 2006, European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry.

[29]  Jessica Y. Lee,et al.  Examining the cost-effectiveness of early dental visits. , 2006, Pediatric dentistry.

[30]  Hiran Perinpanayagam,et al.  Recurrence of early childhood caries after comprehensive treatment with general anesthesia and follow-up. , 2006, Journal of dentistry for children.

[31]  Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. , 2005, Pediatric dentistry.

[32]  R. Billings,et al.  Clinical outcomes for early childhood caries: influence of aggressive dental surgery. , 2004, Journal of dentistry for children.

[33]  L. Mancl,et al.  Reasons for repeat dental treatment under general anesthesia for the healthy child. , 2003, Pediatric dentistry.

[34]  N. Kilpatrick,et al.  Utilization of day stay general anaesthesia for the provision of dental treatment to children in New South Wales, Australia. , 2001, International journal of paediatric dentistry.

[35]  C. Vargas,et al.  Sociodemographic distribution of pediatric dental caries: NHANES III, 1988-1994. , 1998, Journal of the American Dental Association.

[36]  R. Harrison,et al.  Feeding practices and dental caries in an urban Canadian population of Vietnamese preschool children. , 1997, ASDC journal of dentistry for children.