Experiences of Children Undergoing Dental Treatment Under General Anesthesia: A Qualitative Study in Canada

Abstract

With the current move in childhood medicine away from a disease-centered approach to a child-centered approach, an interest in involving children in all aspects of their medical care has emerged. This requires healthcare providers to listen to children’s (and families’) opinions regarding illness, treatment, and health services. Dental treatment under general anesthesia (DTGA) is a common yet problematic approach due to cost and safety concerns for managing severe dental caries in children. The purpose of this qualitative inquiry was to explore children’s and parents’ experiences of DTGA, focusing on the emotional and psychological effects. Semi-structured, in-person interviews, telephone interviews, video diaries, drawings, and a family background information form were used to collect data to gain further understanding of child patients’ experiences of DTGA as they move through the stages of health, illness, treatment, and recovery. A qualitative descriptive design is the methodology of choice when a researcher seeks rich description of a phenomenon about which little is known. The study was designed from a qualitative perspective and thematic analysis was used to analyze data. Brief narrative accounts of the experience of DTGA from the perspective of child patients (children’s drawings, video diaries, and selected parts of the interviews) and their parents (selected parts of the interviews) were constructed. The findings from 12 children (mean age 6.1 years) and their parents (12 mothers and one father, mean age 33.6 years) indicated DTGA is a frightening procedure from the perspectives of both children and parents: parents wished that their children could avoid this “hard route,” and children found the use of the anesthetic gas and balloon procedure “stinky” and “weird.” Parental guilt and the desire of both parents and children to not have to go through the experience again fueled at least short-term compliance with brushing, flossing, and changes in dietary habits such “cutting down on” the consumption of sugar, "pop" and “junk” food. The parents appreciated managing the child’s whole dental problem in a single visit, the humane nature of the surgical staff, and the short wait times to get an appointment for the dental surgery. Since the study revealed that DTGA can have negative emotional impacts for both children and parents, it is imperative to explore ways to improve the GA experience. Specific recommendations were provided by participants for optimizing dental and health services for the children and their families. The children participants provided valuable information to augment that gathered from parents. As children provided insights about dental and medical experiences have scarcely been previously described, future research should fully incorporate children’s perspectives in the evaluation of dental and medical services. Creative activities used here with children as research tools, such as drawings and video or audio diaries, could be included in future research.