Medical Diagnoses, Mode of Residence, and Dental Treatment Demand under General Anesthesia in Special Needs Adults in Innsbruck, Austria. A Retrospective Breakdown of Four and a Half Years

Abstract

Regarding oral/dental care and attendance, special needs individuals depend on their caregivers’ commitment. The purpose of this retrospective data analysis of adults who received dental general anesthesia (DGA) in Innsbruck, Austria, was a breakdown of demographic parameters (including the mode of accommodation/care), medical diagnoses (comprising intellectual/physical disablement (IPD) or psychiatric (anxiety) disorders (PDs)), and dental therapy performed under DGA. The sample was composed of 233 consecutive adults who underwent DGA from January 2015 to June 2019. Data were analyzed with descriptive and comparative statistics. In total, 133 (57.1%) subjects were male and 100 (42.9%) female; 176 (75.5%) had IPD and 57 (24.5%) PDs; 168 (72.1%) were living at private and 65 (27.9%) at nursing homes. Median age (IQR) was 35.6 (25.7–47.2) years. In the total sample, 5 (2–9) teeth were restored and 2 (0.5–6.5) teeth were extracted. Individuals with PDs had more teeth restored (p = 0.01) and extracted (p < 0.001) than individuals with IPD. Private home residents had more teeth restored (p < 0.001) but less teeth extracted (p = 0.003) than nursing home residents. Special needs individuals’ oral health backlog should be tackled in private and institutional care modalities alike.

Unmet Dental Treatment Needs and Barriers to Dental Care of Patients with Special Needs Attending a Dental Teaching Hospital

“…This meant that most patients requiring future urgent treatment received such treatment. This contrasts with reported literature, where many patients with developmental and intellectual disabilities require urgent management under general anesthetic due to a lack of cooperation with dental personnel [11,12]. This could be explained by the sample of patients under review.…”

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

“…Whenever possible, an orthopantomogram is taken. By means of an initial clinical assessment with regard to the severity of disablement (cooperation level) and the nature and extent of dental treatment demand, individuals with disablement are assigned to the hospital’s outpatient students’ program if chairside treatment is deemed feasible, or referred to dental general anesthesia, if patients are judged incapable of cooperation with standard dental treatment [ 20 , 21 ]. At the second appointment, according to clinical and radiological findings, a treatment plan is elaborated, usually consisting of (initial and repeated) oral hygiene instructions as needed, professional tooth cleaning, and, if necessary, periodontal, restorative, or endodontic treatment, tooth extractions, and (mostly removable) prosthetics.…”

The use of general anaesthesia in special care dentistry: A clinical guideline from the British Society for Disability and Oral Health

“…The search identified a large number of studies, only some of which were relevant to SCD delivered under general anaesthesia. A summary of 21 relevant papers 9–29 identified from the formal search is attached (Appendix 2). These are cited in relation to applicable guideline statements and where their quality is adequate to inform a recommendation clearly.…”