Dental caries, age and anxiety: factors influencing sedation choice for children attending for emergency dental care

Objectives: The aim of the study was to examine how physical (dental caries ) and psychosocial (age, dental anxiety and dental health behaviour) factor s, associated with child and parent, influenced dentists' sedation choice w hen a child presents in pain. Methods: 600 parents whose children were aged between 5 and 11 years took part: 200 attended for routine dental care (RD C); the remaining 400 attended as emergency patients and were offered eithe r dental general anaesthesia (DGA) or relative analgesia (RA). The subjects were approached and invited to take part. The researcher was blind as to t he child's pattern of dental attendance and the type of sedation offered. A ll parents and children completed self-reported ratings of dental anxiety. The children's teeth were examined to determine past and present dental car ies experience. Results: The results showed that children who were offered DGA had greater experience of dentinal caries, were younger and dentally an xious. The children offered RA were older, had a higher frequency of brushi ng their teeth with fluoride toothpaste and were also dentally anxious. Dis criminant analysis showed that 2 canonical functions provided clear categor isation of the three treatment groups. Function 1 was a physical (dental ca ries) factor, which was related to the child's experience of dentinal carie s. Function 2 was a psychosocial factor, which was related to the child's a ge, dental anxiety and frequency of tooth brushing. A greater proportion of the variance in the treatment offered was explained by Function 1, suggest ing that the most important factor in the decision to offer DGA was dentina l caries. Function 2 was of lesser importance. Conclusions: The findings ha ve implications for the type of sedation offered to children presenting for emergency care. These children may not otherwise receive treatment and the need to provide less anxiety provoking forms of sedation must be promoted. By doing so, parents who have only brought their children when in pain may take advantage of RDC and the treatments offered to prevent and control de ntal caries and anxiety in their children.