Specialised dental care for children with complex disabilities focusing on child’s functioning and need for general anaesthesia

Abstract

Purpose: To describe and analyse dental care and treatment modalities for children with complex disabilities from a biopsychosocial perspective, with special focus on dental treatment under general anaesthesia (GA) and its relationship to child’s functioning.

Method: An ICF-CY Checklist for Oral Health was completed using structured interview, direct observations, and dental records for patients attending a specialist paediatric dentistry clinic. Descriptive and comparative data analysis was performed. Performance qualifiers from the ICF-CY component Activities and participation were used to calculate functional factors.

Results: Median referral age was 1.5 years and the majority were referred by their paediatrician. Almost all visited a dental hygienist regularly. Dental treatment under GA was common and was combined in 78% of sessions with medical treatment. Children with limitations in their interpersonal interactions and relationships were most likely to have dental GA.

Conclusion: Children without caries experience had been referred for specialist dental care at an earlier age than children with caries experience. GA was a common treatment modality and dental and medical treatments were coordinated under the same GA for a majority of children. By using the ICF-CY, it was possible to identify functional limitations characterising children with disabilities that require dental treatment under GA.

Implications for Rehabilitation

• Early referral to a specialist in paediatric dentistry is valuable for oral disease prevention in children with disabilities.

• Availability of dental treatment under general anaesthesia (GA) is also important.

• Combining dental and medical interventions during the same GA session optimises resources both for the individual and for the health organisation.

• Children with limitations in interpersonal interactions and relationships are more likely to need dental treatment under GA than other children.

Keywords:

• Children
• dental care
• general anaesthesia
• ICF-CY

Disclosure statement

The authors declare no conflicts of interest.