Trends in pediatric dental surgery for severe early childhood caries in Manitoba, Canada.

INTRODUCTION Caries is the most common chronic disease of childhood, and severe forms may necessitate rehabilitative dental surgery. In this study, administrative data related to pediatric dental surgery performed under general anesthesia to treat severe early childhood caries in Manitoba, Canada, were reviewed to determine trends in pediatric dental surgery, as well as geographic, regional and socio-economic variations in surgical rates. METHODS The total number of dental surgery cases performed under general anesthesia was obtained from provincial administrative databases for fiscal years from 1997-98 to 2006-07. Codes from the International Classification of Diseases and Related Health Problems (9th or 10th revision, as appropriate) were used to identify children who underwent extractions under general anesthesia for a slightly earlier fiscal year period (1996-97 to 2005-06). Each 10-year period was divided into two 5-year periods for comparisons over time. Analyses included descriptive and bivariate statistics, with the data being disaggregated by regional health authority (RHA) or by community area (for Winnipeg). Comparisons for which p ≤ 0.05 were defined as statistically significant. RESULTS A total of 18,544 children had dental surgery under general anesthesia between 1997-98 and 2006-07 (mean age ± standard deviation 3.28 ± 1.02 years). Many of the children requiring surgery resided in one northern RHA (26.8%) or the Winnipeg RHA (23.8%). More than half of the RHAs (7/11) displayed significant increases in the rate of surgery, with northern RHAs having the highest rates. Within Winnipeg, 3 of the 12 community areas had significant increases in the rate of surgery. Two inner-city neighborhoods accounted for nearly 50% of surgical cases. The rate of extractions under general anesthesia increased significantly in 6 of the 11 RHAs, with northern RHAs having the highest rates. Four Winnipeg communities experienced significant increases in the extraction rate over time. CONCLUSION Pediatric dental surgery under general anesthesia for treatment of severe early childhood caries is common in Manitoba, and the demand increased in several communities over the study period. These results are being shared with decision-makers and communities to identify regions where oral health promotion is needed.

[1]  R. Schroth,et al.  General Dental Practitioners’ Views on Early Childhood Caries and Timing of the First Dental Visit in Selangor, Malaysia , 2015, Asia-Pacific journal of public health.

[2]  R. Schroth,et al.  Early childhood caries among Hutterite preschool children in Manitoba, Canada. , 2010, Rural and remote health.

[3]  M. Moffatt,et al.  The impact of community workshops on improving early childhood oral health knowledge. , 2010, Pediatric dentistry.

[4]  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.

[5]  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.

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

[7]  R. Schroth,et al.  Determining the prevalence and risk factors for early childhood caries in a community dental health clinic. , 2007, Pediatric dentistry.

[8]  Gina Thornton-Evans,et al.  Trends in oral health status: United States, 1988-1994 and 1999-2004. , 2007, Vital and health statistics. Series 11, Data from the National Health Survey.

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

[10]  R. Schroth,et al.  Prevalence of early childhood caries in 4 Manitoba communities. , 2005, Journal.

[11]  M. Moffatt,et al.  Determinants of early childhood caries (ECC) in a rural Manitoba community: a pilot study. , 2005, Pediatric dentistry.

[12]  M. Moffatt,et al.  Prevalence of caries among preschool-aged children in a northern Manitoba community. , 2005, Journal.

[13]  W. Thomson,et al.  Changes in aspects of children's oral-health-related quality of life following dental treatment under general anaesthesia. , 2004, International journal of paediatric dentistry.

[14]  Robert J Berkowitz,et al.  Causes, treatment and prevention of early childhood caries: a microbiologic perspective. , 2003, Journal.

[15]  B. Peretz,et al.  Preschool caries as an indicator of future caries: a longitudinal study. , 2003, Pediatric dentistry.

[16]  C. V. Hughes,et al.  Future caries susceptibility in children with early childhood caries following treatment under general anesthesia. , 2000, Pediatric dentistry.

[17]  B. Peretz,et al.  A comparison of restorations for children with early childhood caries treated under general anesthesia or conscious sedation. , 2000, Pediatric dentistry.

[18]  A. Ismail.  Prevention of early childhood caries. , 1998, Community dentistry and oral epidemiology.

[19]  T. Al-Shalan,et al.  Primary incisor decay before age 4 as a risk factor for future dental caries. , 1997, Pediatric dentistry.

[20]  E. Sheehy,et al.  A survey of parents whose children had full-mouth rehabilitation under general anesthesia regarding subsequent preventive dental care. , 1994, Pediatric dentistry.