日间全麻下儿童口腔治疗后恢复及影响因素研究

目的:探讨日间全麻下儿童口腔治疗后恢复情况及相关影响因素.方法:日间全麻下口腔治疗患儿418例,年龄2～6岁,ASA分级Ⅰ或Ⅱ级.采用咽喉疼痛、咳嗽、声音嘶哑评分系统及术后恢复质量量表评价麻醉后24 h恢复情况.选择性别、年龄、麻醉时长、治疗牙齿数、七氟醚用量作为麻醉后24 h可能影响恢复因素进行分析.性别分为男、女两...     

家长对全身麻醉下儿童口腔治疗的接受度调查及其影响因素分析

目的 基于问卷调查分析家长对全身麻醉下儿童口腔治疗的接受度并探讨其影响因素。方法 选择2022年3月至2023年2月于第四军医大学口腔医院儿童口腔科行全身麻醉下口腔治疗患儿家长524名。通过调查问卷分析家长对治疗方式的接受度,以及患儿年龄、家长年龄、家庭月收入、家长龋齿状况及对牙科全身麻醉（dental general anesthesia,DGA）治疗过程了解程度等因素对家长接受度的影响。结果 本次调查共发放调查问卷524份,回收506份有效问卷,回收率为96.6%。506名家长中有237名（占46.8%）完全接受治疗方式,250名家长（占49.4%）表示一般接受,有19名家长（占3.8%）表示不能接受。多因素logistic回归模型分析结果显示,患儿年龄（OR=1.635,95%CI:1.115～2.405,P=0.012）、家长龋齿状况（OR=1.652,95%CI:1.029～2.669,P=0.039）及对DGA治疗过程了解程度（OR=0.076,95%CI:0.032～0.171,P <0.001）是家长对全身麻醉下儿童口腔治疗接受度的独立影响因素。结论 家长对全身麻...     

全身麻醉在儿童口腔疾病治疗中的应用

目的：评价全身麻醉在不配合儿童口腔疾病治疗中的临床疗效。方法：收集4—12岁患口腔疾病需治疗病例59例,分别对捆绑强制性多次复诊完成治疗和全麻一次性完成口腔疾病治疗进行临床效果对比评估。结果：全麻下对不配合儿童进行口腔治疗能缩短疗程、提高医疗质量,改善口腔整体卫生水平,减少继发龋、充填物脱落率（P＜0.05）,减轻治疗过程给患儿带来的恐惧、焦虑等负面情绪,有效提高患者的依从性（P<0.05）。结论：对于不配合治疗儿童进行全麻一次性治疗耗时短、疗效高,可降低心理恐惧和焦虑,保护患儿的心理健康,提高患儿的依从性。     

DGA下龋病治疗对儿童口腔健康及生长发育的近期影响

目的 随访在全身麻醉下行龋病治疗的患儿,分析全麻下龋病治疗对儿童口腔健康及生长发育的近期影响。方法 收集2017年2月—2018年1月在上海交通大学医学院附属第九人民医院儿童口腔科进行全身麻醉下龋病治疗并符合研究标准的全部病例。经患儿家长知情同意,研究者在术前、术后随访时检查患儿口腔情况,记录身高、体重,检测龋活跃性。采用SPSS 25.0软件包对数据进行统计学分析。结果 治疗前患儿平均龋均值为14.02,夜奶喂养及过早人工喂养的患儿龋均值明显偏高。术后3个月时龋病复发率为25.67%,6个月时龋病复发率为50%。治疗后患儿龋活跃性发生明显改变,3次随访结果中,龋活性值在术后3个月时最低。全麻治疗后患儿用餐时间显著缩短,进食次数及摄入甜食的频率明显下降,刷牙时间明显延长。术后BMI处于正常范围的儿童数量显著增加。结论 全身麻醉下龋病治疗可在短期内显著降低患儿的龋活跃性,改善患儿的口腔健康行为和发育情况。但大部分患儿治疗后仍具有较高的龋复发风险。     

全身麻醉用于不配合儿童牙体治疗

对于儿童口腔科中低龄、智力残疾和对牙齿治疗极度恐惧等不配合的患儿,行为管理或轻度镇静的方法往往不能使其配合治疗.在国外通常采用全身麻醉[1]下治疗的方法,我国由于医疗条件、观念等原因,全麻下儿童牙体治疗起步较晚.本研究通过总结我院2005年1月至2007年7月全麻下行儿童牙体治疗的病例60例,拟评价全身麻醉在儿童口腔科不配合患儿牙体治疗的应用效果.     

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目的 评价笑气/氧气吸入镇静技术辅助牙科畏惧症患儿口腔治疗的疗效.方法 选择2009年10月至2011年6月来济南市口腔医院就诊,有紧张恐惧情绪,无法完成常规条件下口腔治疗的患儿64例,随机分为试验组和对照组,每组32例.试验组患儿在应用笑气/氧气吸入镇静技术下进行口腔治疗,对照组患儿仅在心理行为诱导下进行口腔治疗.对比两组患儿临床治疗效果及主观焦虑水平与就诊行为改善程度.结果 两组患儿治疗有效率分别为87.5％和62.5％,差异有统计学意义(P＜0.05).治疗后两组患儿儿童畏惧调查表-牙科分量表(CFSS-DS)平均得分和Venham临床焦虑及合作行为级别评分均降低,试验组下降更明显(P＜0.05).结论 笑气/氧气吸入镇静技术能够有效缓解患儿就诊中的焦虑恐惧情绪、改善其就诊行为表现,提高患儿口腔治疗的合作性.     

Tim-3在口腔鳞癌患者外周血NK细胞的表达及意义

目的:探讨T细胞免疫球蛋白粘蛋白分子-3(Tim-3)在口腔鳞癌患者外周血自然杀伤细胞(NK细胞)上的表达及其临床意义.方法:应用流式细胞仪检测72例口腔鳞癌患者和40例健康对照者外周血CD3-CD56+ NK细胞表面Tim-3表达水平,分析其与口腔鳞癌患者临床病理特征的关系.结果:口腔鳞癌患者外周血NK细胞的百分率为(9.30±2.52)％,显著低于健康对照组(17.36±3.15)％ (P＜0.001).口腔鳞癌患者外周血NK细胞表达Tim-3的百分率为(14.35±6.35)％,显著高于健康对照组(1.78±0.86)％(P＜0.001),且与肿瘤临床分期、分化程度及淋巴结转移显著相关(P＜0.01).结论:口腔鳞癌患者外周血NK细胞表达降低,Tim-3在口腔鳞癌NK细胞的表达上调可能与口腔鳞癌的发生发展有关.     

错(牙合)畸形对儿童口腔健康相关生活质量影响的研究

目的:调查错(牙合)畸形对儿童生活质量的影响.方法:选择门诊就诊儿童118名,采用IOTN-DHC指数评价错(牙合)畸形严重程度,采用儿童和家长版Michigan-OHRQoL量表测定对生活质量的影响.结果:错(牙合)畸形在咀嚼等客观方面对家长和儿童影响较一致,家长对儿童牙齿的主观评价较儿童自身评价高;收入较高与教育程度高的家长评价错(牙合)畸形对患儿的生活质量影响较大.结论:错(牙合)畸形对儿童的口腔健康相关生活质量有影响,影响程度与家长收入及教育程度有关.     

成人固定及隐形正畸不同阶段口腔健康相关生活质量分析

目的比较佩戴金属自锁托槽和无托槽隐形矫治器的成人患者不同治疗阶段的口腔健康相关生活质量, 探究性别、牙齿健康因素及治疗时期对口腔健康相关生活质量的影响。方法本研究为前瞻性研究, 选择佩戴金属自锁托槽和无托槽隐形矫治器的患者各55例(18～38岁), 所有患者在正畸治疗前(T0)、排齐整平(T1)、关闭间隙(T2)、精细调整(T3)阶段分别进行口腔健康影响程度量表-14问卷调查, 计算口腔健康相关生活质量得分, 比较性别、牙齿健康因素及不同治疗时期对佩戴两种矫治器患者的口腔健康相关生活质量的影响。结果在隐形和自锁组的T0、T1、T2和T3期, 牙齿健康因素分级对口腔健康相关生活质量无显著性影响。在T1期, 隐形和自锁组均为男性的口腔健康相关生活质量更高(隐形组男18.56±2.79, 女20.54±3.87, P=0.035;自锁组男24.46±1.77, 女26.03±2.77, P=0.015)。两组患者在功能限制领域的T1[隐形组4.00(3.00, 4.00), 自锁组4.00(3.00, 5.00)P=0.038]和T3[隐形组0.00(0.00, 1.00), 自锁组1.00...     

儿童口腔健康认知和行为对其口腔健康状况的影响

目的:调查上海市儿童口腔健康认知、行为及其口腔健康现状,分析影响儿童口腔健康的因素.方法:采用儿童口腔健康调查问卷和中文版儿童口腔健康相关生存质量量表(child oral health impact profile,COHIP),对上海市城区2018年12月—2019年2月期间的387名小学生进行问卷调查.采用SPS...     

Sensitivity and responsiveness of the Chinese ECOHIS to dental treatment under general anaesthesia

Lee GHM, McGrath C, Yiu CKY, King NM. Sensitivity and responsiveness of the Chinese ECOHIS to dental treatment under general anaesthesia. Community Dent Oral Epidemiol 2011; 39: 372–377. © 2011 John Wiley & Sons A/S Abstract – Objective: This study aimed to investigate the sensitivity and responsiveness of the Chinese version of the Early Childhood Oral Health Impact Scale (ECOHIS) to dental treatment under general anaesthesia (GA). Methods: A consecutive sample of primary caregivers of children (aged 5 and younger) with early childhood caries (ECC) attending a university hospital dental clinic for dental treatment under GA was recruited over a 12‐month period. Caregivers self‐completed the ECOHIS prior to and 3 months following their child dental treatment under GA. In addition, caregivers rated the change in their child’s overall health condition compared to before treatment on a global transition scale. Sensitivity of the measure was assessed by determining distribution changes in ECOHIS scores; responsiveness was assessed by investigating whether the observed changes took the form of a gradient according to the global transition judgement, in terms of the observed change in scores and effect size. Results: Following treatment under GA, there was significant changes in ECOHIS scores (P < 0.01) and many of its sub‐domains. The magnitude of change (effect size) of the total ECOHIS following treatment was 0.89 and among sub‐domains ranged from ?0.29 to 1.33. There was an observed gradient in the changes of ECOHIS scores (and effect sizes) in relation to global transition judgement of oral change following treatment, supporting the responsiveness of the measure. Conclusions: The Chinese version of ECOHIS is sensitive and responsive to dental treatment of ECC under GA.     

Follow-up of children’s oral health-related quality of life after dental general anaesthesia treatment

Objective: Our aim was to analyze longitudinally the impact of young children’s dental general anaesthesia (DGA) treatment on their OHRQoL and to determine their post-operative oral health status at the six-month follow-up together with parental ratings of their children’s oral health.

Material and methods: We conducted a prospective follow-up study of OHRQoL among Lithuanian child patients treated under general anaesthesia (n?=?144). The study consisted of clinical dental examinations performed by two examiners at the time of DGA and at the six-month recall, along with OHRQoL surveys and data collected from the patients’ files. The dmft index and Silness–Löe plaque index served as clinical measures. The survey tool for assessing the children’s OHRQoL was the previously tested Lithuanian version of the ECOHIS. The Wilcoxon signed-rank test served for the statistical analysis (p?Results: The ECOHIS scores clearly decreased post-operatively, indicating a significant (p?p?Conclusions: This longitudinal study showed a sustained improvement in the children’s OHRQoL six months after their DGA treatment. Post-operative parental ratings of their child’s oral health were higher after the DGA treatment, but the children exhibited insufficient oral hygiene and new caries lesions. An appropriate follow-up system for children receiving DGA treatment with special focus on preventive care is needed.     

Psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS)

Background

Oral disorders can have a negative impact on the functional, social and psychological wellbeing of young children and their families and cause pain/discomfort for the child. Oral health-related quality of life (OHRQoL) has emerged as an important health outcome in clinical trials and healthcare research. The Early Childhood Oral Health Impact Scale (ECOHIS) is a proxy measure of children's OHRQoL designed to assess the negative impact of oral disorders on the quality of life of preschool children. The objective of this study was to evaluate the psychometric properties of the Brazilian version of the ECOHIS (B-ECOHIS).

Methods

This investigation was carried out in preliminary and field studies. The preliminary study comprised a cross-sectional study carried out in the city of Petropolis, Brazil. A sample of 150 children from two to five years of age was recruited at a public hospital. In the field study, an epidemiological survey was carried out in public and private preschools of Belo Horizonte, Brazil. The B-ECOHIS was answered by 1643 parents/caregivers of five-year-old male and female preschool children. In both phases, oral examinations were performed by a single previously calibrated dentist. Reliability was determined through test-retest reliability and internal consistency. Validity was determined through convergent and discriminant validities. The correlation between the scores obtained on the child and family impact sections was assessed.

Results

In the preliminary (P) and field (F) study, test-retest reliability correlation values were 0.98 and 0.99 for the child impact section and 0.97 and 0.99 for the family impact section, respectively. The B-ECOHIS demonstrated internal consistency: child impact section (P: α = 0.74; F: α = 0.80) and family impact section (P: α = 0.59; F: α = 0.76). The correlation between the scores obtained on the child and family impact sections was statistically significant (P: r_s = 0.54; F: r_s = 0.62; p ≤ 0.001). In both phases of the study, B-ECOHIS scores were significantly associated with the decayed, missing and filled teeth index, decayed teeth and discolored upper anterior teeth (p < 0.05).

Conclusion

The B-ECOHIS proved reliable and valid for assessing the negative impact of oral disorders on the quality of life of preschool children.     

CHANGES IN PARENTAL SATISFACTION AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PRESCHOOL CHILDREN AFTER RECEIVING ATRAUMATIC RESTORATIVE TREATMENT WITH OR WITHOUT PRIOR SILVER DIAMINE FLUORIDE APPLICATION

ObjectiveTo investigate the short-term and long-term changes in parental satisfaction and oral health-related quality of life (OHRQoL) of preschool children after receiving atraumatic restorative treatment (ART) with or without prior silver diamine fluoride (SDF) application.MethodsIn a randomized controlled trial, preschool children with cavitated dentine caries lesions in their primary teeth were randomly assigned into two groups to receive either application of SDF solution or placebo (tonic water) on the caries lesions 10 weeks before receiving ART restorations. The information on parental satisfaction and OHRQoL of the children were collected through self-completed questionnaires at baseline, the 6-month and the 24-month follow-up. A five-point scale, from 1 (very dissatisfied) to 5 (very satisfied), was used by parents to indicate their satisfaction with their child's dental conditions. A higher parental satisfaction score indicates that parents were more satisfied with their child's dental condition. In addition, the Chinese version of Early Childhood Oral Health Impact Scale (ECOHIS) was adopted to assess the children's OHRQoL, and a higher ECOHIS score indicates greater negative impacts of oral health on the child's OHRQoL.ResultsA total of 194 children participated in this study, with 101 and 93 children receiving SDF and placebo application before ART restorations, respectively. After placement of ART restorations, at 6-month and 24-month follow-up, parental satisfaction scores with their child's dental health status were significantly higher compared with those at baseline (P <.001) indicating the parents were more satisfied at follow-ups. Regarding OHRQoL, no statistically significant changes were found in the child impact section (CIS), family impact section (FIS) and total ECOHIS scores in both study groups at the 6-month follow-up. In contrast, at the 24-month follow-up, the CIS (P = .025) and total ECOHIS scores (P = .015) of the children in the control group were significantly higher than those at baseline (greater negative impacts), but not the FIS score.ConclusionIn this study, after one-off placement of ART restorations irrespective of prior SDF application, short-term and long-term parental satisfaction with their child's dental health status was improved, but not the children's OHRQoL.     

Impact of oral diseases and disorders on oral health-related quality of life of preschool children

Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of oral diseases and disorders on oral health‐related quality of life of preschool children. Community Dent Oral Epidemiol 2011; 39: 105–114. © 2010 John Wiley & Sons A/S Abstract – Background: The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well‐being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. Objective: To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health‐related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. Methods: Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children’s OHRQoL and socioeconomic conditions. Two calibrated dentists (κ > 0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0 = caries free; 1–5 = low severity; ≥6 = high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. Results: In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P < 0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain (P > 0.05). The increase in the child’s age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P < 0.05). The multivariate adjusted model showed that the high severity of ECC (RR = 3.81; 95% CI = 2.66, 5.46; P < 0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR = 0.93; 95% CI = 0.87, 0.99; P < 0.001). Conclusions: The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.     

Translation and validation of a Chinese language version of the Early Childhood Oral Health Impact Scale (ECOHIS)

Objective.  This study aimed to adapt the Early Childhood Oral Health Impact Scale (ECOHIS) for pre-school children in a Chinese speaking community and to investigate its psychometric properties (validity and reliability).
Methods.  A Chinese language version of the ECOHIS was derived through a forward–backward translation and tested for face and content validity among a focus group. A convenient sample of pre-school children ( n  = 111) was recruited (including a sub-sample with early childhood caries and caries-free children). Parents of the children self-completed the derived Chinese-ECOHIS measure. Validity of the measure was assessed by investigating the relationship between dental caries status and Chinese-ECOHIS scores (construct and criterion validity). A sub-sample of the parents repeated the ratings of the measure to enable reliability assessments. Both internal and test–retest reliability were determined.
Results.  A Chinese version of ECOHIS was derived with minor modification to the original version. Chinese-ECOHIS scores were associated with children's caries experience (dmft) ( r =  0.66, P  < 0.05) supporting convergent validity. In addition, variations in ECOHIS scores were apparent with respect to caries and caries-free groups ( P  <   0.001), supporting the ability to distinguish between patient groups. Cronbach's alpha values (internal reliability) for total ECOHIS score were 0.91 and intraclass correlation coefficient value (test–retest reliability) was 0.64.
Conclusions.  A Chinese version of the ECOHIS was developed and demonstrated acceptable validity and reliability. These findings can enable assessments of pre-school child oral health-related quality of life in Chinese speaking communities.     

Testing responsiveness to change for the early childhood oral health impact scale (ECOHIS)

Abstract – Objectives: The Early Childhood Oral Health Impact Scale (ECOHIS) is a recently developed oral health‐related quality of life instrument designed to assess the impact of oral health problems in 0–5‐year‐old children. It has previously been validated as discriminative instrument. The goal of this study was to investigate the responsiveness to change of the ECOHIS. Methods: Data were collected from a convenience sample of 101 parents of 0–5‐year‐old children attending a hospital dental clinic for dental treatment. The ECOHIS was completed by parents prior to dental treatment and 2 weeks later. Subjects were also asked a global transition judgement concerning change between the second and first completion of the ECOHIS instrument. Responsiveness to change of the ECOHIS was analysed through: (i) a comparison of ECOHIS change scores with a global transition judgment by study subjects; (ii) an assessment of the statistical significance of within‐group change in scores over time for groups reporting improvement, stability and deterioration; (iii) an estimation of the ECOHIS’s sensitivity; and (iv) an investigation the effect size of the ECOHIS. Results: Of the 101 subjects recruited, 94 had full datasets. Their data were used for the analyses reported in this paper. Pre‐ and post‐treatment distributions of ECOHIS scores were strongly distributed towards no oral health impacts. Among the 94 subjects, 51.1% reported improvement, 42.6% reported no change and 6.4% reported deterioration following treatment, using the global transition judgement. The mean ECOHIS change scores for these three groups were ?0/9, +0.7 and +6.5 respectively, although none of the within‐group changes were statistically significant. The effect size for those reporting improvement was small (0.15) but for those reporting deterioration was moderate‐to‐large (0.69). Sensitivity ranged from 0.61–0.79 depending on the size of the cut‐off point, with a change of 3 points demonstrating the best sensitivity to false positive ratio (0.79 versus 0.41 respectively). Conclusion: In this sample with low levels of problems, the ECOHIS has demonstrated some limited ability to respond to change. Further work in a larger sample with higher levels of problems is needed to investigate the instrument’s ability to respond to change when it has occurred.     

A comparison of a generic and oral health–specific measure in assessing the impact of early childhood caries on quality of life

Lee GHM, McGrath C, Yiu CKY, King NM. A comparison of a generic and oral health–specific measure in assessing the impact of early childhood caries on quality of life. Community Dent Oral Epidemiol 2010; 38: 333–339. © 2010 John Wiley & Sons A/S Abstract – Objectives: The aim of this study was to compare the performance of a generic health‐related quality‐of‐life measure, the Pediatric Quality of Life Inventory Version 4.0 (PedsQL? 4.0) and an oral health–specific quality‐of‐life measure, the Early Childhood Oral Health Impact Scale (ECOHIS) in assessing the impact of severe early childhood caries (S‐ECC) on the children’s quality of life. Methods: A trained and calibrated examiner conducted a clinical oral assessment of 111 children (mean age: 49 ± 12 months): 64 of whom were categorized as having S‐ECC and 47 as being caries‐free. Primary caregivers completed a Chinese version of the PedsQL? 4.0 and the ECOHIS. Clinical examinations were conducted blind of the parental assessments. Results: The ECOHIS scores were significantly higher for the S‐ECC group than for the caries‐free group (P ≤ 0.001). No significant difference was found between the PedsQL? 4.0 scores in relation to caries status, except for the subscale of physical functioning (P = 0.04). Correlation of caries status with the ECOHIS scores was strong (r = 0.66; P < 0.01). No significant correlation was found between PedsQL? 4.0 scores and caries status (r = 0.02; P > 0.05). Conclusions: The oral health–specific measure, ECOHIS, shows better discriminant property between children with S‐ECC and caries‐free children than the generic measure, PedsQL? 4.0. The ECOHIS appears more sensitive than PedsQL? 4.0 in assessing the impact of dental caries on the life quality of preschool children.     

Effect of povidone-iodine on Streptococcus mutans in children with extensive dental caries

PURPOSE: The purpose of this pilot project was to determine the effect of a 10% povidone-iodine solution on plaque Streptococcus mutans and on incidence of new caries in young children following dental rehabilitation under general anesthesia. METHODS: Twenty-five children ages 2 to 7 years, scheduled for dental treatment under general anesthesia, were enrolled. Children in the experimental group (N = 13) had povidone-iodine applied 3 times at 2-month intervals. Control children (N = 12) had no treatment. Plaque samples were taken from all children at baseline, 6 months and cultured for total bacteria and S mutans. Dental examinations were conducted at baseline, 6 months, and 1 year. RESULTS: Experimental and control children had similar dietary habits, caries experience, and S mutans levels at baseline. All children's S mutans counts decreased significantly at 6 months (P = .003). The difference between the 2 groups was not significant (P = .58). At 1 year, 5 of 8 children in the control group had new caries compared to 2 of 11 children in the experimental group (P = .06). Povidone-iodine was well accepted by participating families. CONCLUSIONS: Extensive one-time restorative dental treatment resulted in a significant suppression S mutans levels at 6 months. Further exploration of the role of povidone-iodine in caries management is indicated.     

Medicaid costs associated with the hospitalization of young children for restorative dental treatment under general anesthesia

OBJECTIVE: This paper examines the cost to the Iowa Medicaid program of hospitalizing young children for restorative dental care under general anesthesia, and describes the dental services received in this setting. METHODS: Medicaid dental claims for young children receiving restorative dental care under general anesthesia during fiscal year 1994 were matched with corresponding hospital and anesthesia claims. RESULTS: The total cost to the Medicaid program of treating a child in the hospital under general anesthesia was $2,009 per case. Less than 2 percent of Medicaid-enrolled children under 6 years of age who received any dental service accounted for 25 percent of all dollars spent on dental services for this age group, including hospital and anesthesia care. The most frequent type of procedure was stainless steel crowns (SSCs), with an average of almost six per case. CONCLUSIONS: Early identification, prevention, and intervention are critically important to prevent the costly treatment of children with ECC in hospital operating rooms.