Dental extractions do not predict further use of dental general anesthesia in people with disabilities: A longitudinal analysis

Abstract

ObjectivesThis paper describes treatments completed under dental general anesthesia (DGA) for a cohort of adults with disabilities. This patient cohort was followed up a number of years later to determine outcomes and identify factors that predict further use of DGA.MethodsA retrospective patient record review and cross‐sectional survey was carried out on a convenience sample of 64 patients who had previously received dental treatment under general anesthesia. Patient record review extracted data on patient demographics and treatment provided under DGA. Cross‐sectional survey a number of years post‐DGA collected data on oral care habits and current oral health based on a standardized clinical examination. Statistical analysis was carried out to identify predictors of repeat DGA.ResultsParticipants received extensive treatment under DGA including preventive care, restorations, extractions, and root canal treatment. At follow‐up 89.1% of participants had gingival disease and 56.3% had active dental caries. The mean number of teeth present was 21.2 (SD 6.9, range 6–32). Only caries risk status was found to be a significant predictor (p = 0.03) with those with a high caries risk status 6.9 times (95%CI 1.2–39.3) more likely to receive a second DGA.ConclusionsDentists extract teeth for people with disabilities under DGA in the mistaken belief that this will avoid the need for further DGA. This study found that extraction of teeth does not prevent the need for repeated episodes of DGA. Therefore, dentists should stop extracting teeth for this reason. Rather, if dentists want to avoid further DGA, they should do the basics well: consistent, evidence‐based caries risk assessment and risk reduction.

Dental Treatment in Special Needs Patients and Uncooperative Young Children: A Retrospective Study

“…The literature reports that dentists used to extract the teeth of SNPs under GA in the mistaken belief that this would avoid the need for further interventions. McGeown et al refuted this hypothesis and strongly recommended evidence-based caries risk assessment and prevention as the main goal of SNP treatment [13]. We must not forget that the mouth represents a "calling card", a first interface, so it is a fundamental element for the general well-being of individuals and acceptance by society [14].…”

Retrospective Evaluation of 20 Years of Outpatient Dental Services to Adults with Disabilities at the Dental Hospitals of the Medical University of Innsbruck, Austria

“…Generally, extractions of compromised teeth are probably carried out more expeditiously in persons with disablement than in non-disabled individuals in order to effect rapid and durable pain relief and to avoid straining treatment sessions. However, extensive extraction treatment in preference to restorative dentistry seems not advisable and does not preempt further need for dental therapy [ 25 ].…”