title: Oral health status of children with special health care needs receiving dental treatment under general anesthesia at the dental clinic of Taipei Veterans General Hospital in Taiwan.
abstract: BACKGROUND
  Oral health is crucial to individual growth and development. However, oral health care is often overlooked in children with special health care needs (CSHCN). We investigated current oral health status and unmet dental needs of CSHCN in Taiwan.
  
  
  METHODS
  We performed a retrospective study of consecutive CSHCN cases receiving first-time comprehensive dental treatment under general anesthesia at Taipei Veterans General hospital from 2001 to 2010. We retrieved clinical data including age, sex, types, and severity of disability, caries experience index [decayed, extracted, and filled teeth (deft) index for primary dentition/decayed, missing, and filled teeth (DMFT) index for permanent dentition], malocclusion, and treatment modalities from medical charts for analysis. The correlation between different groups of CSHCN regarding the deft/DMFT indices and treatment modalities was analyzed statistically.
  
  
  RESULTS
  Our study included 96 children, ranging in age from 2.4 years to 14.3 years (mean age 6.8 ± 3.3 years). The deft/DMFT index was significantly higher in the younger age group (2-6 years; 13.8 ± 4.3) compared with the older group (> 6 years; 10.5 ± 5.3; p < 0.001). The mean number of total treated teeth was 14.2 ± 3.8, and no differences existed among disability groups (p = 0.528) and age groups (p = 0.992). For the treatment modality, the number of pulp therapies with crown restoration was higher in the younger age group than in the older group. At the time of the study, 53 CSHCN had reached their full permanent dentition. We observed significantly more malocclusion of full permanent dentition in the older age group (91%) than in the younger group (35%; p < 0.001).
  
  
  CONCLUSIONS
  Unmet dental needs and caries experience indices remain high in CSHCN, regardless of the types and severity of disability. However, the younger the age at which CSHCN received their first dental treatment, the more effective the dental rehabilitation was. Parental education regarding early dental intervention and a preventive approach for enhanced oral care is mandatory.
authors.affiliation: Division of Pedodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Division of Oral and Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Faculty of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Division of Pedodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Tzong-Ping
authors.initials: TP
authors.lastname: Tsai
authors.affiliation: Division of Pedodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: wyshih@vghtpe.gov.tw.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Shih
mesh_terms: D000293:Adolescent; D000766:Anesthesia, Dental / Q000379:methods*; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D003729:Dental Care; D019988:Children with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D009909:Oral Health / Q000592:standards*; D012189:Retrospective Studies; D013624:Taiwan
keywords: comprehensive dental care; deft/DMFT index; dental care for children; disabled children