A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Science in Dentistry Johannesburg, 2014 / Dental caries is one of the most common chronic childhood diseases and its prevalence is increasing globally. Dental general anaesthetic is resource intensive and not without risk. These services exist frequently to manage children with advanced stages of dental disease. The patients accessing this facility, as well as the treatment they receive, require analysis in order to address the demand for this form of treatment. Objectives: • To determine the age, ethnicity, home language, socioeconomic status, distance travelled and how many patients accessing this facility are physically or mentally compromised. • To determine the source of referral and the referral request. • To determine the waiting time before treatment. • To record the treatment received. • To record the average duration of each procedure. ! xi! • To determine how many of the patients were not scheduled but received treatment. • To determine the incidence of repeat dental general anaesthetic. • To assess how gender and ethnicity might influence the treatment outcomes. • To compare the treatment received by the mentally and physically compromised patients to that received by the rest of the study population. Methods: This was a retrospective, observational, cross-sectional study of paediatric patients undergoing dental general anaesthetic at Wits Dental Hospital in 2011. A total of 516 patients were treated at this facility in 2011 and 459 met the inclusion criteria of being ≤ 16 years. A sample size of 300 was calculated. One hundred and ninetyfour( 64.9%) of the sample patient files were retrieved. Data was also collected from the theatre register and day sheet(appointment register). Information was extracted from the various sources and recorded on a data capture sheet. This was then captured in Excel and exported into SPSS, Version 21, for analysis. Results: The mean age of healthy children in this study was 4,90 years. Of the healthy patients 54.3% were male. Black patients were underrepresented in this group. English(27.2%) ! xii! and Zulu(26.5%) were the most commonly reported home languages. As expected most patients were classified as younger than 6 years or committed children according to the hospital classification based on assets and income. More than half the population travelled distances greater than 10km for treatment. Mentally and physically compromised patients comprised 13.7% of the study population. 20.4% of patients had been referred to this facility and private dentists accounted for the majority of the referrals. The waiting time was 5.03 months before treatment. An average of 9.19 extractions were performed on healthy patients and the mean duration of each procedure was 29.07 minutes. 17.4% of patients were found to be unscheduled. Only 1% of the patients had a history of previous dental general anaesthetic. Recommendation: Addressing the social determinants of disease in the study population will reduce the demand for this type of service. The severity of dental disease can be improved with early diagnosis. Prevention and promotion programs need to be designed with the specific demographic characteristics of these patients in mind. The study highlighted areas for further research

Thesis (B.S.)--University of Toronto, 1929.

Thesis (B.S.)--University of Toronto, 1929.

Thesis (M.S.)--University of Michigan, 1971. / Typescript (photocopy). Includes bibliographical references (leaves 60-64). Also issued in print.

Thesis (doctoral)--Universität Göttingen, 1933.

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.

Thesis (doctoral)--Munich, 1934. / Includes bibliographical references (p. 22-23).

Thesis (M.S.)--University of Michigan, 1971. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 60-64).

Thesis (doctoral)--Munich, 1934. / Includes bibliographical references (p. 22-23).

Colored photographs included. / Thesis (M.Sc.D.)--Boston University. Henry M. Goldman School of Graduate Dentistry, 1983 (Endodontics) / Bibliography: leaves 59-63. / Profound anesthesia is of paramount importance to the endodontist when treating vital cases. Many a clinician has experienced the frustration of attempting root canal therapy upon an inadequately-anesthetized “hot” mandibular tooth. Consequently, many different methods of anesthetizing lower teeth have been proposed, including; 1. Mandibular block with a lingual supplementary injection as described by Schilder[1] 2. Periodontal ligament injection devices[2,3,4] 3. Gow Gates[5-9] 4. Akinosi[10] 5. Intraosseous[11] 6. Interseptal[12] This project　studied the efficacy of the first　two methods in delivering mandibular anesthesia for endodontic purposes.　Its main objective was　to answer the question of whether an instrument such as the Ligmaject[tm] is a beneficial　addition　to　the endodontic armamentarium. Questionaires were completed by graduate endodontic students at B.U.S.G.D. 50 teeth were anesthetized using a mandibular block and lingual　supplemental injection. 63 teeth were anesthetized using the Ligmaject[tm]. Results demonstrated that the Ligmaject[tm]; 1.　Yielded faster onset　of anesthesia. 2. Provided shorter duration of anesthesia (30 min. to one hour) than the mandibular block (2-4 hours). 3. Was generally more comfortable for patients than the mandibular block.　However, the PDL-injection was extremely painful for some patients. 4. Was　less reliable　than　the mandibular block and lingual　supplemental in rendering vital mandibular teeth　totally numb. A large number Of PDL-injected teeth needed mandibular blocks in order to obtain access for the intrapulpal injections. This required additional manipulations of the patients. 5. Should not be used on undebrided areas or teeth with suppurative periodontal 1esions. 6. Has the potential for initiating periodontal damage even on healthy periodontiums as demonstrated by a case report　documented with preoperative and postoperative radiographs and photos. Preservation of the attachment　apparatus is a critical element　of any dental　discipline. Despite its advantage of shorter anesthetic duration, the use of the Ligmaject[tm] does not　seem consistent with this philosophy.