Langzeitergebnisse zur Mundgesundheit bei Kindern mit frühkindlicher Karies nach Sanierung in Intubationsnarkose

Abstract

Introduction: Early Childhood Caries (ECC) has a lasting impact on the oral health of children. This study aimed to examine the oral health in the mixed dentition of children with ECC 3–4 years after rehabilitation under general anaesthesia (GA) in comparison to children without ECC.Materials and methods: A number of 42 children with ECC that had been treated for caries under GA (investigation group, IG) and 45 children with a low caries prevalence (control group, CG) were included into this case-control-study. The median age was 8 years (Y) and 1,5 months (M) in the IG and 8 Y and 6 M in the CG. The therapy under GA, which was initiated endotracheal, had been completed 3 Y and 9 M ± 10 M before the initiation of this investigation. The clinical examination included the determination of oral health parameters. In addition, socio-demographic data, oral hygiene–and eating habits were determined by using a questionnaire. T-test, Chi-Quadrat-test and Fisher’s exact test were used for the statistical analysis. The level of significance was p ≤ 0.05.Results: The dmft (without incisors) was 7.83 ± 2.44 in the IG and 1.96 ± 2.13 in the CG (p < 0,001). The IG also showed a higher caries experience in the permanent dentition (DMFT: IG: 0.67 ± 0.95 vs. CG: 0.18 ± 0.44; p = 0.004). The rate of rehabilitation was significantly lower in the IG than in the CG (19.0 % vs. 58.8 %; p < 0.001). In both groups, fissure sealants were found at an equal frequency. The Turesky-modified Quigley-Hein plaque index (QHI) showed 2.40 ± 0.49 in the IG and 2.71 ± 0.69 in the CG (p = 0.020). While the breast feeding habits did not significantly differ between both groups, children of the IG significantly more often continued to drink from a bottle over the age of 2 years (18.9 % vs. 2.2 %; p = 0.020). They also consumed cariogenic drinks (52.0 % vs. 10.3 %; p = 0.001), particularly cariogenic tea (46.9 % vs. 9.7 %; p = 0.001) more frequently. At the time of the investigation, no significant difference between the groups regarding the consumption of cariogenic drinks was observed (55.3 % vs. 73.2 %; p = 0.096). Cariogenic foods predominated in the IG (17.5 % vs. 2.4 %; p = 0.029), whereas fruits and vegetables were consumed less frequently (76.2 % vs. 93.3 %; p = 0.025). The mothers of the IG had a lower level of education (p = 0.005) and were rarely under employement (64.3 % vs. 86.7 %; p = 0.015).Conclusion: Almost 4 years after therapy of ECC under GA, the caries activity in the mixed dentition of these children was still higher, probably due to an unfavourable nutritional behaviour. Tooth brushing instructions, professional cleaning and local fluoride application as well as an intensive nutrition counselling have to be part of a risk-related follow-up. A special challenge remains the accessibility of parents with a lower level of education.