Mortality and Morbidity in Office-Based General Anesthesia for Dentistry in Ontario

Abstract

Our objective was to estimate the prevalence of mortality and serious morbidity for office-based deep sedation and general anesthesia (DS/GA) for dentistry in Ontario from 1996 to 2015. Data were collected retrospectively in 2 phases. Phase I involved the review of incidents, and phase II involved a survey of DS/GA providers. In phase I, cases involving serious injury or death for dentistry under DS/GA, sourced from the Office of the Chief Coroner of Ontario and from the Royal College of Dental Surgeons of Ontario (RCDSO), were reviewed. Phase II involved a survey of all RCDSO-registered providers of DS/GA in which they were asked to estimate the number of DS/GAs administered in 2015 and the number of years in practice since 1996. Clinician data were pooled to establish an overall number of DS/GAs administered in dental offices in Ontario from 1996 to 2015. Prevalence was calculated using phase I (numerator) and phase II (denominator) findings. The estimated prevalence of mortality in the 20-year period from 1996 to 2015 was 3 deaths in 3,742,068 cases, with an adjusted mortality rate of 0.8 deaths per 1 million cases. The estimated prevalence of serious morbidity was 1 injury in 3,742,068 cases, which adjusts to a serious morbidity rate of 0.25 per 1 million cases. The mortality rate found in this study was slightly lower than those published by earlier studies conducted in Ontario. The risk of serious morbidity was found to be low and similar to other studies investigating morbidity in office-based dental anesthesia.

Dental decision‐making under general anesthesia for patients with disabilities: A qualitative study

“…Modern research advocates for non-extraction approaches under DGA to improve function and quality of life 43 and emphasizes the safety of DGA. 33 As part of this change in perceptions, the definitions of success and failure of dental treatment under GA need to be redefined. As a profession we need to view the ongoing trends in edentulism for adults with disabilities as failure and adjust our decisionmaking accordingly.…”

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

“…In these cases, dental general anesthesia (DGA) is a commonly used approach to provide optimized treatment conditions [13,14]. Under defined precautions (including a thorough pre-operative medical assessment), DGA has been considered a safe procedure when carried out by a specialized and well-equipped team [13][14][15][16], as is the case at the University Hospital of Innsbruck, Austria. However, particularly in medically compromised individuals, a certain risk of peri-or postoperative anesthetic complications remains [13,17].…”

Postoperative Morbidity of Dental Paediatric Patients Treated under General Anaesthesia at a University Hospital: An Observational Study

“…is kind of anaesthetic technique makes it possible to resolve all oral health problems in a single visit without the need for the child's cooperation [2,3].…”

“…[4][5][6] Postoperative morbidity signs and symptoms reported in children treated under GA included pain, nausea, vomiting, sore throat, sleepiness, and haemorrhage wound in the mouth. [5,[7][8][9][10] Postoperative mortality was also reported [2,11].…”

“…In some children and individuals with special care needs who have extensive oral healthcare needs, acute situational anxiety, uncooperative age-appropriate behaviour, immature cognitive functioning, disabilities, or medical conditions various levels of sedation may be necessary to ensure compliance with dental treatment, including minimal sedation, moderate sedation, deep sedation, or general anaesthesia (GA) to receive dental treatment in a safe and humane fashion. [ 1 , 2 ] There has been a change in recent years in the perception of professionals regarding the usefulness of general anaesthesia in children, both in young patients with extensive oral problems and/or difficult to manage behaviour and in disabled or medically compromised patients, as well as in oral surgery procedures. This kind of anaesthetic technique makes it possible to resolve all oral health problems in a single visit without the need for the child's cooperation [ 2 , 3 ].…”