Children often don’t get the oral healthcare they need because of anxiety, costs, the number of needed visits to treat a single problematic tooth, and other complications. As a result, many dental issues get so bad, they need to be treated in a hospital operating room under general anesthesia, which requires longer wait times and greater expense.
In-office general anesthesia (IOGA) attempts to address these cases by offering complete comprehensive oral healthcare to pediatric patients in a faster, more comfortable, and less expensive capacity. Researchers at the Cincinnati Children’s Hospital Medical Center and the University of Cincinnati recently compared the use of traditional oral sedation with IOGA for pediatric patients undergoing dental procedures at the center.
The researchers conducted a retrospective analysis examining oral sedation occurring pre-IOGA and post-IOGA accessibility with IOGA procedures. There were 930 pre-IOGA oral sedation patients ranging in age from 21 months to 13 years; 508 post-IOGA patients ranging in age from 21 months to 15.5 years; and 418 IOGA patients ranging in age from 21 months to 13 years.
The researchers focused on the percentage of completed cases within each patient population as well as the percentage of radiographic exams, serious adverse effects, procedure time, and repeat patients.
The percentage of completed cases with oral sedation fell slightly from pre-IOGA (88.6%) to post-IOGA (85.2%), but 99.5% of all IOGA cases were completed. Dental radiographs increased from pre-IOGA to post-IOGA oral sedation patients, 63.4% versus 3.5%, and 100% of IOGA patients had complete radiographs.
There were no serious adverse effects in any of the oral sedation patients and only one case in the IOGA patients (0.2%). The overall procedure time was longer for IOGA cases (84.9 minutes) compared with pre-IOGA (67.9 minutes) and post-IOGA (68.1 minutes). The recovery time for IOGA cases was 15 minutes, while oral sedation could take up to 30 minutes. The number of repeat patients decreased from pre-IOGA to post-IOGA patients, 11.1% versus 5.9%, and only 0.9% of IOGA patients had a repeat visit.
The researchers concluded that IOGA improves access to treatment for pediatric dental patients. The completion of cases and the number of radiographs and full dental examinations all improve dramatically, enabling necessary and comprehensive oral healthcare for pediatric patients, the researchers said.
The study, “Impact of Instituting General Anesthesia on Oral Sedation Care in a Tertiary Care Pediatric Dental Clinic,” was published by Anesthesia Progress.