title: Dental anxiety, distress at induction and postoperative morbidity in children undergoing tooth extraction using general anaesthesia.
abstract: OBJECTIVE
  To report on the prevalence of postoperative morbidity in children undergoing tooth extraction under chair dental general anaesthetic (CDGA) in relation to pre-operative dental anxiety and anaesthetic induction distress.
  
  
  METHODS
  A prospective national study.
  
  
  METHODS
  Twenty-five Scottish DGA centres in 2001.
  
  
  METHODS
  Four hundred and seven children (mean age 6.6 years; range: 2.3 to 14.8 years; 52% male). Before CDGA, the Modified Child Dental Anxiety (MCDAS) and Modified Dental Anxiety (MDAS) Scales were completed for children and accompanying adult respectively; the latter also returned a morbidity questionnaire 24 hours and one week post-operatively. Anaesthetic induction distress was scored immediately before CDGA induction using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS).
  
  
  RESULTS
  The mean MCDAS score was 24.2 (population norm 18.2); 21% of adults were anxious. Forty-two per cent of children had induction distress; this related to their MCDAS scores (r=0.43, p<0.001, Pearson Product Moment Correlation Coefficient). Morbidity at 24 hours and seven days was 63% and 24% respectively; this related to MCDAS scores (r=0.15, p=0.029 and r=0.17, p=0.009, Pearson Product Moment Correlation Coefficient) and to induction distress (chi2=7.14, p=0.007 and chi2=11.70, p=0.001).
  
  
  CONCLUSIONS
  The majority of children suffered next day morbidity and many still had symptoms a week later. Most children were dentally anxious; this related to induction distress and postoperative morbidity.
authors.affiliation: University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK. m.t.hosey@dental.gla.ac.uk
authors.forename: M T
authors.initials: MT
authors.lastname: Hosey
authors.forename: L M D
authors.initials: LM
authors.lastname: Macpherson
authors.forename: P
authors.initials: P
authors.lastname: Adair
authors.forename: C
authors.initials: C
authors.lastname: Tochel
authors.forename: G
authors.initials: G
authors.lastname: Burnside
authors.forename: C
authors.initials: C
authors.lastname: Pine
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000768:Anesthesia, General / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D016854:Dental Anxiety / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D010290:Parents / Q000523:psychology; D011183:Postoperative Complications / Q000523:psychology*; D011446:Prospective Studies; D012606:Scotland; D011795:Surveys and Questionnaires; D014081:Tooth Extraction / Q000523:psychology*