Dental Treatment Under General Anesthesia in a Day Care Surgery Setting

Brailo, Vlaho; Janković, Bernard; Lozić, Marin; Gabrić, Dragana; Kuna, Tihomir; Stambolija, Vasilije; Verzak, Željko

doi:10.15644/asc53/1/7

Cited by 13 publications

(13 citation statements)

References 10 publications

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“…Special needs patients often have a reduced ability to perform oral hygiene themselves and access to dental services is reduced. This in turn can result in an increased risk of caries and periodontal disease [ 5 – 7 ]. This hypothesis is clearly reflected in the numbers of carious or unsustainable teeth in this analysis.…”

Section: Discussionmentioning

confidence: 99%

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Outpatient dental care for people with disabilities under general anaesthesia in Switzerland

2020

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Background: Life expectancy of people with permanent disabilities has increased. The dental care of these vulnerable patients is one of the greatest challenges for the dentist and the dental team due to limited or non-existent cooperation and the associated lack of health competence. In order to be able to provide safe and acceptable, quality dental treatment without psychological and physical stress for these patients, it is therefore necessary to resort to sedation or general anaesthesia (GA) under medical supervision. The aim of the analysis is to highlight the need for dental treatment performed under GA for people with disabilities and the associated indications and treatment patterns. Methods: Ten-year retrospective analysis of outpatient dental care under GA for people with disabilities. Results: Of all adult patients (n = 221) who attended the GA pre-assessment, 69.7% (n = 154) received dental treatment under GA based on the clinical findings or in cases of suspected pain. Most patients received one GA. A total of 205 dental treatment sessions were performed under GA mostly for conservative (n = 442, 52%) and surgical (n = 389, 45.8%) procedures. Endodontic treatment (n = 19, 2.2%) was rare. The failure rate related to all teeth in need of treatment (n = 850) was 5.1% (n = 43), in most cases due to secondary caries (n = 40; 93.0%). Patients were enrolled in an annual recall for dental examination and prophylaxis without GA. Non-compliant patients for whom oral hygiene was impossible received a periodic GA. Conclusion: There is a high need of people with disabilities for dental treatment under GA. Main indications for treatment under GA are dental complaints, pain or suspected pain. Dental care can be successful if, for the benefit of patients with special needs, all carers cooperate closely. Caregivers have to be trained in nutrition control as well as in oral hygiene. These factors in conjunction help to prevent dental emergencies.

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Section: Discussionmentioning

confidence: 99%

“…This often leads to oral diseases (caries, periodontitis, etc. [ 5 – 7 ]), which increase the need for dental treatment [ 5 , 8 , 9 ]. In addition, people with intellectual disabilities are often unable to recognise dental problems and/or oral pain or discomfort.…”

Section: Introductionmentioning

confidence: 99%

Outpatient dental care for people with disabilities under general anaesthesia in Switzerland

2020

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“…Dental care is necessary to prevent and treat oral infections, cavities, and toothache. Poor oral hygiene is one of the public health problems which majorly affect children and patients with mental disorders and physical disabilities (21). Thus, there is now more emphasis on active surveillance and prevention of caries (1,22).…”

Section: Discussionmentioning

confidence: 99%

Diş Hekimliğinde Kullanılan İleri Davranış Yönlendirme Tekniklerinin Değerlendirilmesi: Sedasyon ve Genel Anestezi

Gürbüz¹

2020

Osmangazi̇ Journal of Medicine

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Although most of the dental procedures can be held in the office setting, sedation or general anesthesia is required in some of the patients. The aim of this study was to review patients who underwent dental procedures under anesthesia with the emphasis on patient characteristics, procedural and anesthetic properties, and to consider this issue from various aspects. Medical records of 362 patients who underwent dental procedures under sedation or general anesthesia were analyzed. Demographic data, the reasons for treatment under anesthesia, anesthetic, and procedural characteristics were recorded. Patients were evaluated under three groups according to their ages (<10years: children; n=159, 10-24 years: young people; n=113, ≥25 years; n=90: adults). Noncompliance was the main reason for dental surgery under anesthesia in children (76.1%) and young people (41.6%). Mental retardation (26.7%) and extreme dental phobia (24.4%) were found to be the most frequent reasons for dental surgery under anesthesia in adults. For the reversal of rocuronium, while neostigmine was the primary choice in pediatric patients, sugammadex was the most preferred reversal agent in adults. Patients undergoing dental procedures under anesthesia constitute a specialized patient group (e.g. pediatric patients and patients with special needs). Therefore, implementing nonsurgical interventions and postponing elective surgeries to an appropriate time must be taken into consideration. For the safety and the quality of the dental procedure, the choice of anesthesia technique must be made according to the risk and benefit analysis.

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“…5 The rationale for GA in dental treatments is to allow complete oral rehabilitation, which includes pulpal treatment, extractions of non-restorable teeth, dental restorations, and/or stainless-steel crowns (SSCs) in a single session. 5 Lately there has been a trend towards fewer root treatments in primary teeth (pulpotomy/ pulpectomy) and more of extractions, SSCs, and fissure sealing of teeth under GA. 6 Most pediatric dental GA candidates are medically compromised children who are uncooperative but otherwise healthy children and children with early childhood caries. 6 This study included children aged from birth to 13 years indicated for full mouth rehabilitation who were otherwise healthy as well as medically compromised children.…”

Section: Introductionmentioning

confidence: 99%

“…5 Lately there has been a trend towards fewer root treatments in primary teeth (pulpotomy/ pulpectomy) and more of extractions, SSCs, and fissure sealing of teeth under GA. 6 Most pediatric dental GA candidates are medically compromised children who are uncooperative but otherwise healthy children and children with early childhood caries. 6 This study included children aged from birth to 13 years indicated for full mouth rehabilitation who were otherwise healthy as well as medically compromised children. These children were entitled for treatment by the Bahrain Defense Force (BDF) military.…”

Section: Introductionmentioning

confidence: 99%

Oral Rehabilitation Under General Anesthesia for Pediatric Patients at Bahrain Defense Force Hospital: A Retrospective Study

2021

J Bah Med Soc

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Objective: To analyze data on full mouth rehabilitation under general anesthesia (GA) performed at the Bahrain defense force (BDF) Military Hospital with focus on patient characteristics, type of procedures, reasons of treatment under general anesthesia and post-operative complications.Material and Methods: Retrospective review of 281 patients treated under GA at the BDF day case surgery unit. Patient's (sex, age) clinical data (diagnosis, reasons of treatment, number of stainlesssteel crowns (SSCs) used, extracted teeth, endodontic treatment, fluoride applications and prophylaxis treatment, postoperative complications were collected.Results: Two hundred and sixty patients were treated under GA due to their uncooperative behavior, 13 patient were medically compromised, and 7 patients were elective patients. All patients were discharged on the same day, with no complications, excluding 4 patients, who reported within two of months follow-up with pain. Conclusion:Within the limitations of this study, it is important to educate parents on oral hygiene and caries preventions in order to minimize future failures and the need to repeat the GA, for their children. Oral rehabilitations under GA may be required for the treatment of non-compliant patients. Treatment under GA is safe and effective in providing dental care for non-compliant and medically complex patients.

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Dental Treatment Under General Anesthesia in a Day Care Surgery Setting

Cited by 13 publications

References 10 publications

Outpatient dental care for people with disabilities under general anaesthesia in Switzerland

Outpatient dental care for people with disabilities under general anaesthesia in Switzerland

Diş Hekimliğinde Kullanılan İleri Davranış Yönlendirme Tekniklerinin Değerlendirilmesi: Sedasyon ve Genel Anestezi

Oral Rehabilitation Under General Anesthesia for Pediatric Patients at Bahrain Defense Force Hospital: A Retrospective Study

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