目的:本次回顾,基于实践的研究调查了患有先天性心脏病(CHD)的芬兰儿童牙科护理中的行为管理问题(BMP)。
方法:在国家ProCardio数据库中确定了所有在1997年至1999年之间出生的心脏手术儿童(n=570)。要求该人群提供初级牙科护理记录,并最终从211名患者那里获得。关于性别的信息,诊断,从ProCardio数据库收集心脏手术和围手术期护理的数量,CHD被分类为分流/狭窄/复杂/其他缺陷。BMP/牙科恐惧的数据,口腔清醒镇静,牙科全身麻醉(DGA)以及6、12和15岁的过去和现在的龋齿指数(d/D,dmft/DMFT)进行评估。
结果:在19%的研究人群中发现了有关行为管理问题或牙科恐惧的注释。牙科护理中的BMP在男孩中更为频繁。重新手术的孩子,术后重症监护住院时间和住院时间更长,和并发症没有比其他更多的BMP。那些被诊断患有综合症的儿童经常比其他人患有更多的BMP。过去和现在的龋齿经历与BMP显着相关,需要口服有意识的镇静和DGA。口腔清醒镇静,17/211、2/221和24/211CHD患者使用氮氧化物镇静和牙科全身麻醉,分别。
结论:龋齿仍然是CHD人群中与BMP相关的主要因素。需要口服有意识的镇静和DGA相当普遍。为了保持良好的口腔健康和避免BMP的发展,CHD儿童受益于健康促进和预防保健。
OBJECTIVE: This retrospective, practice-based
study investigates behaviour management problems (BMPs) in dental care among Finnish children with operated congenital heart disease (CHD).
METHODS: All the heart-operated children born between the years 1997 and 1999 were identified in the national ProCardio database (n = 570). Primary dental care records were requested from this population and were eventually received from 211 patients. Information on gender, diagnosis, number of heart operations and perioperative care were collected from the ProCardio database, and the CHDs were categorised as shunting/stenotic/complex/other defects. Data on
BMP/dental fear, oral conscious sedation, dental general anaesthesia (DGA) and past and present caries indices at 6, 12 and 15 years (d/D, dmft/DMFT) were assessed.
RESULTS: Notes on behaviour management problems or dental fear were found in 19% of the
study population. BMPs in dental care were more frequent among boys. Children with re-operations, longer post-operative intensive care stay and hospitalisation, and complications had not more BMP than others. Those children diagnosed with syndromes had more
BMP often than the rest. Past and present caries experience were significantly associated with BMP, need of oral conscious sedation and DGA. Oral conscious sedation, nitrogen oxide sedation and dental general anaesthesia were used in 17/211, 2/221 and 24/211 CHD patients, respectively.
CONCLUSIONS: Dental caries remains a main factor associated with
BMP in the CHD population. Need for oral conscious sedation and DGA were rather common. To maintain a good oral health and to avoid development of BMP, CHD children benefit from focus in health promotion and preventive care.