Dental treatment under general anesthesia for special‐needs patients: analysis of the literature

Abstract

The aim of the present review was to identify the studies published on dental treatment under general anesthesia for special-needs patients. A comprehensive search of the reported literature from January 1966 to May 2012 was conducted using PubMed, Medline, and Embase. Keywords used in the search were "dental treatment under general anesthesia", "special-needs patients", "medically-compromised patients", and "children", in various combinations. Studies published only on dental treatment under general anesthesia and in English were included. Only 10 studies were available for final analysis. Age range from 1 to 50 years, and restorative procedures, were most prevalent. Only two studies discussed repeated general anesthesia, with rates of 7.2% and 10.2%. Over time, the provision of general anesthesia for special-needs patients has changed from dental clinics to general hospitals. The demand for dental treatment for special-needs patients under general anesthesia continues to increase. Currently, there are no certain accepted protocols for the provision of dental treatment under general anesthesia.

The effect of dentist experience on the treatment of individuals with disability under general anesthesia

“…This argument has been used to justify an increase in restorative procedures, mainly fillings, such as that detected in this study starting the first 6‐year period. This trend has led to a predominance of restorative versus surgical treatments in the series published to date …”

“…3,4 Intellectual disability and behavior disorders continue to be the most common systemic diagnoses among patients who undergo treatment under GA. 5 There is virtually unanimous agreement in the literature in considering caries as the main indication for performing treatment, 6 followed by periodontal disease. 7 We detected significant disparity among the published studies in terms of the dental procedures performed, 8 although extractions generally predominated, 9 which can be explained by the advanced state of tooth decay at the time of the operation and in many cases by the inability to follow appropriate postoperative maintenance. 8 Recent studies have reported a considerable increase in restorative treatments.…”

“…7 We detected significant disparity among the published studies in terms of the dental procedures performed, 8 although extractions generally predominated, 9 which can be explained by the advanced state of tooth decay at the time of the operation and in many cases by the inability to follow appropriate postoperative maintenance. 8 Recent studies have reported a considerable increase in restorative treatments. 10 In a number of series, preventive procedures (such as fissure sealants and fluoride application) are almost routinely performed.…”

“…There are significant discrepancies in the literature in terms of the follow‐up appointments and the assessment of results . However, numerous authors have confirmed that dental treatment under GA not only improves these patients’ oral health but also has a positive impact on their quality of life, which affects the rest of their family …”

A contribution of CAD/CAM treatment of a dental trauma in a special care patient

“…In this particular case of a special needs patient, ceramic veneer by CAD/CAM was the best solution in terms of longevity, aesthetics, and prevention of caries . It has been shown that restorative procedures are often affected by problems of attendance and high failure rates before 5 years . For our young patient, direct composite restoration of an incisal edge would not have been a good solution because cooperation was insufficient to enable an aesthetic and lasting rehabilitation to be made, specifically in a patient who chewed strongly on any object inserted in her mouth.…”