A research report submitted to the Faculty of Health
Sciences, University of the Witwatersrand, in partial
fulfillment of the requirements for the degree
of
Master of Science in Dentistry
Johannesburg, 2014Dental caries is one of the most common chronic childhood
diseases and its prevalence is increasing globally. Dental
general anaesthetic is resource intensive and not without
risk. These services exist frequently to manage children
with advanced stages of dental disease. The patients
accessing this facility, as well as the treatment they
receive, require analysis in order to address the demand for
this form of treatment.
Objectives:
• To determine the age, ethnicity, home language,
socioeconomic status, distance travelled and how many
patients accessing this facility are physically or
mentally compromised.
• To determine the source of referral and the referral
request.
• To determine the waiting time before treatment.
• To record the treatment received.
• To record the average duration of each procedure.
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• To determine how many of the patients were not
scheduled but received treatment.
• To determine the incidence of repeat dental general
anaesthetic.
• To assess how gender and ethnicity might influence the
treatment outcomes.
• To compare the treatment received by the mentally and
physically compromised patients to that received by the
rest of the study population.
Methods:
This was a retrospective, observational, cross-sectional
study of paediatric patients undergoing dental general
anaesthetic at Wits Dental Hospital in 2011.
A total of 516 patients were treated at this facility in
2011 and 459 met the inclusion criteria of being ≤ 16 years.
A sample size of 300 was calculated. One hundred and ninetyfour(
64.9%) of the sample patient files were retrieved. Data
was also collected from the theatre register and day
sheet(appointment register). Information was extracted from
the various sources and recorded on a data capture sheet.
This was then captured in Excel and exported into SPSS,
Version 21, for analysis.
Results:
The mean age of healthy children in this study was 4,90
years. Of the healthy patients 54.3% were male. Black
patients were underrepresented in this group. English(27.2%)
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and Zulu(26.5%) were the most commonly reported home
languages. As expected most patients were classified as
younger than 6 years or committed children according to the
hospital classification based on assets and income. More
than half the population travelled distances greater than
10km for treatment. Mentally and physically compromised
patients comprised 13.7% of the study population. 20.4% of
patients had been referred to this facility and private
dentists accounted for the majority of the referrals. The
waiting time was 5.03 months before treatment. An average of
9.19 extractions were performed on healthy patients and the
mean duration of each procedure was 29.07 minutes. 17.4% of
patients were found to be unscheduled. Only 1% of the
patients had a history of previous dental general
anaesthetic.
Recommendation:
Addressing the social determinants of disease in the study
population will reduce the demand for this type of service.
The severity of dental disease can be improved with early
diagnosis. Prevention and promotion programs need to be
designed with the specific demographic characteristics of
these patients in mind. The study highlighted areas for
further researc
