452 - Comparing Pediatric Dental Service Utilization before and after OR Treatment

Abstract:

Introduction: Dental caries is one of the most prevalent chronic diseases in US children [1]. When pediatric dental patients present multiple dental needs or pose behavioral challenges, comprehensive dental treatment in the Operating Room (OR) under general anesthesia is often used [2]. While this comprehensive treatment restores the patient's oral health, the long-term impact of this intervention on dental service utilization, including routine follow-up and emergency dental visits, is unknown.



Purpose and

Methods: The purpose of this study was to determine if there were statistical differences between the number of routine and emergency dental visits for pediatric patients from the University of Toledo (UT) Dental Service before and after receiving comprehensive dental treatment in the OR. The study analyzed charts for 272 pediatric patients between 2 and 12 years of age who underwent OR dental treatment between July 2023 and June 2024 at the UT Dental Service or its affiliated hospitals. Paired-samples Student's t-Tests compared the average number of routine and emergency visits before and after OR dental treatment for the entire patient cohort and a series of relevant subgroups.



Results: For the entire group, there was a statistically significant reduction in both routine and emergency dental visits (p < 0.001 for both), with a dramatic 86.5% decrease in emergency dental visits and an alarming 58.7% decrease in routine dental visits.



Conclusion: Dental treatment in the OR is superbly effective in reducing the need for emergency dental visits for pediatric patients, strongly supporting its value. On the contrary, a concurrent reduction in routine follow-up visits presents a significant area of opportunity for improving long-term dental preventive care. The reduction in post-OR routine dental visits is likely linked to caretakers' decreased perceived dental need, logistical barriers, lack of proper tracking of patient referrals, or patient migration to a new dental home. The findings underscore the need to revise post-operative discharge protocols to enhance caregiver education, thereby preventing the recurrence of severe dental disease. Future studies should longitudinally track patient follow-up compliance, including transfers of care, to prevent the need for repeat OR procedures.



References:



< ![1] Fleming, E., & Afful, J. (2018). Prevalence of total and untreated dental caries among youth: United States, 2015–2016. NCHS Data Brief, (317), 1–8.

< !2] American Academy of Pediatric Dentistry. (2020). Technical brief: Use of general anesthesia for dental procedures in pediatric patients. The Reference Manual of Pediatric Dentistry.



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