Special Health Care Needs
Ami Gadhia, DMD (she/her/hers)
Resident
University of Southern California
Los Angeles, California, United States
Jose Polido, DDS
Children's Hospital Los Angeles
Alexander Alcaraz, DMD
Program Director, Advanced Pediatric Dentistry
University of Southern California, Herman Ostrow School of Dentistry
Los Angeles, California, United States
Purpose: The purpose of this study is to review the oral health status of children with pediatric feeding disorders at Children’s Hospital Los Angeles (CHLA) feeding and dental clinics. Furthermore, the aim is to evaluate the correlation of known risk factors for this population and frequency of operating room events.
Methods: A retrospective chart review of subjects with diagnosis of pediatric feeding disorders ages 0-18 with SNOMED CT codes was conducted. Bivariate analyses were conducted to ascertain the differences in risk factors by outcomes of caries and general anesthesia experience. Risk factors assessed included prematurity, age at G-tube placement, oral intake, medical diagnoses, age of first dental visit, developmental delay, and pulmonary complications.
Results: Out of 145 charts, 130 were included. Fifty patients (38.5%) had dental treatment completed under general anesthesia, and of these, 18 patients returned to the operating room multiple times for dental treatment under general anesthesia. The risk factors associated with higher odds of requiring more than one dental GA event included: DMFT of one or more at initial exam, history of pneumonia, history of neuromotor challenges, history of requiring Cavitron scaling completed in clinic, and requiring advanced behavior management techniques (such as protective stabilization).
Conclusions: OR utilization appears to be disproportionately high for this population, despite lower caries risk. This study identified specific risk factors that may place a patient at a higher likelihood of requiring dental treatment under general anesthesia, allowing identification of at-risk patients by dental providers and a subsequent individualized approach to dental management for this population.