الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Children with special health care needs are at increased risk for acquiring dental disease. Neuromuscular, acquired, or genetic disorders in many cases cause alterations or defects in skeletal and facial structures.
Dental treatment under general anesthesia (GA) may be required to deliver effective treatment for dental caries, when other behavioral or pharmacological management techniques fail.
Parental/caregiver perceptions of children’s OHRQoL are especially important for CSHCN due to the fact that many of these patients are with limitations in their cognitive capacities and communication skills. These families also come to face great emotional and financial strain in trying to gain access to all the necessary health services for their children.
The increased attention towards the CSHCNs led to the focus on their oral health related quality of life and treatment efficiency after oral rehabilitation in different countries. However, these findings cannot be generalized to other populations. Limited information is available on the effect of oral rehabilitation under GA of CSHCN on their oral health related quality of life in Egypt. Hence, the objective of this study was to assess changes in the oral health related quality of life among children with special health care needs before and one month after oral rehabilitation under general anesthesia performed at Department of Pediatric Dentistry, Faculty of Dentistry, Alexandria University.
The study was cross-sectional analytical study based on a validated pre and post-operative questionnaires. The Child Oral Health-Related Quality of Life (COHRQoL) questionnaire is a method of measuring OHRQoL and it includes Parental- Caregiver Perceptions Questionnaire (P-CPQ) and the Family Impact Scale (FIS).
Parental- Caregiver Perceptions Questionnaire (P-CPQ) consisted of 16 items (closed-ended questions) which were grouped into four domains: Oral symptoms items (n=4), Functional limitations items (n=4), Emotional wellbeing (n=4) and Social wellbeing (n=4).
Family Impact Scale (FIS) consisted of 8 items which were grouped into three domains: Parental/family activity (n=4), Parental emotions items (n=2), Family conflict (n=2).
The study took place at the Department of Pediatric Dentistry and theatres at Faculty of Dentistry, Alexandria University. Parents/caregivers of CSHCN were interviewed on the day of operation where the study was explained and an informed consent was obtained. Pre-operatively, investigator explained the Child Oral Health Related Quality of Life (COHRQoL) questionnaires. Parents/caregivers filled it on the day of GA. It was answered according to the child’s oral state within the 3 past months.
The total study population consisted of 49 caregivers of CSHCN who were scheduled to undergo full mouth rehabilitation under general anesthesia between July 2017 and June 2018. The follow-up response rate was 95.91%, 47 participants coming for follow up and completed the questionnaire with only 2 dropouts (one participant refused to complete the study and the other participant could not be contacted during the study period).
In the present study a significant improvement in OHRQoL was reported by parents/caregivers of SCHCNs for each domain of P-CPQ. The total score of P-CPQ also revealed a significant post-operative improvement at p=0.001.
The improvement regarding FIS section was significant for each domain at p=0.001. with the best improvement was related to the parental emotions domains as the parents felt relief after the removal of the burden of oral symptoms and complications related to their CSHCNs and observing the improvement of their children quality of life. Also the total score of FIS section was also significant at p=0.001.
Our study emphasizes that the OHRQoL of CSHCN markedly improved after oral rehabilitation under GA as well as their families indicating the importance of oral rehabilitation for those children.