Evaluation of treatment methods and age-genderdistributions under general anesthesia for healthy childpatients and child patients with special treatment needs: Retrospective study

Aim: General anesthesia is one of the advanced behavior management techniques used in some special cases where treatment can not be applied in a clinical setting in pediatric dentistry. The aim of this study is to retrospectively evaluate pediatric patients who were given indications and had dental treatments under general anesthesia at Aydın Adnan Menderes University Faculty of Dentistry between December 2013 and September 2021. The systemic conditions, general information, preventive and dental treatments of the treated patients were compared. Materials and Methods: Patients who applied to our clinic between 2013-2021 and whose data were recorded in the system after their treatment was completed under general anesthesia were examined. The treatments applied to the patients under general anesthesia, the duration of anesthesia, the general information of the patients and their systemic health status were recorded by accessing the patient files and by means of epicrisis reports. Age, gender, dft/DMFT values of the patients, duration of anesthesia and systemic health conditions and treatments applied to the patients were statistically evaluated. Results: A total of 436 pediatric patients, 199 girls (45.6%) and 237 boys (54.4%) aged 2-14 years, were included in the study. The mean age of the patients was 5.96±2.29 years. 47.9% (n=209) of the patients were between the ages of 2-5, 50.5% (n=220) were between the ages of 6-12 and 1.6% (n=7) were over the age of 12. 73.2% (n=319) of the patient group were systemically healthy. 8.5% (n=37) consist of patients with systemic disease and without disability. 18.3% of the patients (n=80) consisted of disabled patients. The mean dft value of all patients was 6.19±4.014; The mean DMFT value was found to be 2.70±2.772. The mean duration of anesthesia for all patients was 86.71±33.95 minutes. Primary tooth extraction in 36.7%, permanent tooth extraction in 4.8%, primary tooth restoration in 89.2%, permanent tooth restoration in 51.1%, primary tooth pulpotomy in 23.2% of patients, 8.5% primary tooth root canal treatment, 12.8% PÇK application, 8% primary tooth fissure sealant, 37.4% permanent tooth fissure sealant, 20% fluoride application and 2%, scaling and root planing was applied to 2.5% of them. Conclusion: The number of healthy patients in the study is higher than the number of disabled patients. Among the patients participating in the study, there are healthy patients at a younger age and disabled patients at an older age. This situation makes us think that healthy patients are affected by early childhood caries (ECC) and have cooperation problems at a young age, while disabled patients apply to the dentist later because of the priority of systemic health problems. It was observed that the mean dft value was higher in all patients at younger ages, and the mean DMFT value of patients at older ages was higher in disabled patients. It is seen that young children and disabled patients have a high caries rate. The longest duration of anesthesia was found in healthy children aged 2-5 years, and it is thought that high caries rate increases the duration of anesthesia. When the treatments were examined, it was seen that more primary tooth extraction was performed in healthy patients between the ages of 2-5 and 6-12 years, and more permanent tooth extraction was performed in disabled patients between the ages of 6-12. It was observed that less primary tooth restoration was performed on disabled patients aged 2-5 and 6-12 years, and more permanent tooth restoration was performed in disabled patients aged 6-12 and over 12 years. This situation occurred because of the radical treatment to prevent the risk of recurrent general anesthesia due to the difficulty of oral care in disabled patients. The most applied treatment under general anesthesia was found to be primary and permanent tooth restoration.