# Development and Validation of the SCAN-Score to Indicate General Anesthesia for Dental Care in Children

## TL;DR

This paper introduces a new scoring system, SCAN-score, to help pediatric dentists decide whether to use general anesthesia for uncooperative children.

## Contribution

The novel contribution is the development and validation of the SCAN-score as an objective tool for indicating general anesthesia in pediatric dental care.

## Key findings

- The SCAN-score showed high sensitivity (0.99) and specificity (0.94) at a cutoff of 10.
- Children managed chairside had a mean score of 5.6, while those under general anesthesia had a mean score of 12.9.
- The ROC curve estimate was 0.994, indicating strong diagnostic accuracy.

## Abstract

Background: General anesthesia is an approach used to address behavior issues in pediatric dentistry. This indication often relies on the practitioner’s discretion rather than objective criteria. We developed SCAN-score to assist pediatric dentists in the case of doubt to indicate general anesthesia for uncooperative children. The study aims were to assess the validity of the SCAN-score, which aims to indicate general anesthesia or chairside management for dental care. Methods: A retrospective study was performed on children aged between 2 and 10 years who received dental care. The SCAN-score combined three item scales (age, need of care, behavior) and three additional factors: communication barriers, permanent teeth caries, and local anesthesia contraindications. Mean scores were estimated. An ROC curve was constructed with sensitivities and specificities obtained. Results: The study included 284 children, with 154 treated through chairside methods and 130 treated under general anesthesia. The mean score was 5.6 ± 2.8 in the chairside management group and 12.9 ± 1.9 in the general anesthesia group. The sensitivity of the score (cutoff at 10) was 0.99, and the specificity was 0.94. The estimate of the ROC is 0.994. Conclusions: The SCAN-score appears to be an excellent tool to support the practitioner’s decision to refer to general anesthesia care.