General Anesthesia for the Early Childhood Caries Treatment: A Case Report

Ines Cardoso Martins, Ana Coelho, Sara Magalhães, Joana Castanho, Rita Ramos, Paula Marques
Pós-Graduação de Odontopediatria, Universidade de Lisboa, Faculdade de Medicina Dentária, R. Professora Teresa Ambrósio,Cidade universitária, Lisboa, Portugal

Background: Early childhood caries (ECC) is an multifactorial infectious disease of the primary teeth of children which if not intervened at an early stage can lead to severe destruction of the teeth and can also affect their sucessors.

Young children with ECC are often in pain, anxious and present several teeth with deep carious lesions. For these patients an approach like general anesthesia is indicated. The goals are establishment of a healthy dentition, behaviour management, patient welfare and production of a positive psychological response to treatment.

The decision process to apply this technique should mostly rely on the type and age of the patient, the amount and complexity of the dental treatments and the cost.

Case Report: A 3 year-old asthmatic child was referred for treatment of EEC displaying painful symptoms and lack of cooperation. Clinical examination revealed multiple severe carious lesions in the deciduous dentition. The upper incisors revealed extensive decays and the posterior teeth where also affected. The mother refers to perform a sugar-rich diet and lack of tooth brushing.

Results: In the first appointment preventive advises were given to the caregivers and fluoride varnish was applied after dental plaque removal.

This patient was treated under general anesthesia. Most of the teeth were treated with resin restorations and composite strip crowns on anterior teeth were performed. The post surgical appointment showed a good recovery. Preventive measures were once again stressed and a 3 month tight recall schedule was set.

Conclusion: ECC is a global epidemic, affecting the quality of life of young children and their families, with effects on growth and development in addition to an economic burden caused by the need for extensive oral rehabilitation. However, the successful outcome of mouth rehabilitation largely relies on the ability of patients and/or their parents/educators to comply with preventive care.

Ines Cardoso Martins