Childhood caries and dental surgery under general anesthesia: an overview of a global disease and its impact on anesthesiology.
Childhood caries and dental surgery under general anesthesia: an overview of a global disease and its impact on anesthesiology.
复制标题
全身麻醉下的儿童龋齿和牙科手术：全球疾病及其对麻醉学影响的概述。
DOI：
10.1097/aia.0000000000000385
复制
发表时间：
2023
影响因子：
0.6
通讯作者：
Lee,HelenH
中科院分区：
文献类型：
--
作者：
Patel,Shiragi;Fantauzzi,AndrésJ;Patel,Raj;Buscemi,Joanna;Lee,HelenH
幼儿龋病是世界范围内最常见的儿童慢性疾病之一。1美国儿科牙科学会（AAPD）将ECC定义为6岁以下儿童因乳牙龋齿而出现一个或多个空腔或非空腔病变、缺牙或补牙。由于相关的身体、情感和社会经济负担，ECC是一个主要的公共卫生问题。口腔卫生行为不佳（例如，刷牙不足，饮食中添加糖含量高）的幼儿有发生严重早期儿童龋齿（S-ECC）的风险，这是牙科手术的指征。2-9 S-ECC定义为：(1)3岁以下儿童的任何光滑面龋；(2) 3 - 5岁儿童前牙光滑表面出现一个或多个空化、缺失或填充；(3) 3岁儿童腐朽、缺失或填充分数大于等于4分，4岁儿童大于等于5分，5岁儿童大于等于6分。由于儿童的发育阶段与年龄、疾病的严重程度以及治疗程序的强度和程度相结合，全麻牙科手术（DGA）通常在临床上有指征。S-ECC对儿童健康的影响波及整个系统和心理健康，对一个人的生活质量产生负面影响。11-14 S-ECC与几种全身性健康合并症有关，包括疼痛、胃肠道疾病、咀嚼困难、营养不良、长期牙病和肥胖。此外，与没有龋齿的儿童相比，患有S-ECC的儿童有更高程度的焦虑/抑郁、睡眠问题、攻击行为和注意力缺陷/多动问题。15 .除了影响个人健康外，S-ECC在人口层面上还与三级卫生服务的利用有关，而三级卫生服务往往稀缺、昂贵，且结构不针对疾病的病因。患有严重疾病的儿童到急诊科接受牙痛的急性治疗或需要DGA。16 .影响人口口腔健康的上游因素，即社会决定因素，是可改变的因素，最终影响麻醉师的临床实践，麻醉师越来越多地参与到幼儿的治疗中。
Early childhood caries (ECC) is one of the most common chronic childhood diseases worldwide. 1 Defined by the American Academy of Pediatric Dentistry (AAPD) as the presence of one or more cavitated or noncavitated lesions, missing, or filled tooth due to caries in any primary tooth in a child under 6 years of age, ECC is a major public health concern due to the associated physical, emotional, and socioeconomic burdens. Young children who have poor oral health behaviors (eg, inadequate tooth brushing, diet high in added sugar) are at risk for developing severe early childhood caries (S-ECC), which is an indication for dental surgery. 2–9 S-ECC is defined as:(1) Any smooth-surface caries in children younger than 3 years old;(2) One or more cavitated, missing, or filled smooth surfaces in anterior teeth in children 3 to 5 years old; or (3) decayed, missing, or filled score of greater than or equal to 4 in children 3 years old, greater than or equal to 5 in children 4 years old, or greater than or equal to 6 in children 5 years old. 10 Dental surgery under general anesthesia (DGA) is often clinically indicated due to a combination of the child’s development stage related to age, disease severity, and intensity and extent of treatment procedures. The impact of S-ECC on a child’s health ripples out across systemic and psychosocial well-being, negatively affecting one’s quality of life. 11–14 S-ECC is associated with several systemic health comorbidities including pain, gastrointestinal disorders, difficulty chewing, malnutrition, long-term dental disease, and obesity. 12–14 In addition, children with S-ECC experience higher degrees of anxiety/depression, sleep problems, aggressive behavior, and attention deficit/hyperactivity issues compared with children who have no caries. 15 In addition to impacting individual health, S-ECC on a population level is associated with utilization of tertiary health services that are often scarce, expensive, and not structured to address the etiology of the disease. Children with severe disease present to the emergency department for acute treatment for a toothache or require DGA. 16 The upstream factors that influence population oral health, that is social determinants, are modifiable factors that ultimately affect the clinical practice of anesthesiologists, who are increasingly involved in the treatment of young children.