Outpatient, dental care of adult vulnerable patients under general anaesthesia-a retrospective evaluation of need for treatment and dental follow-up care

Clin Oral Investig. 2021 Apr;25(4):2407-2417. doi: 10.1007/s00784-020-03564-2. Epub 2020 Sep 15.

Abstract

Objectives: To analyse the treatment needs of patients who had received dental treatment under GA and the effectiveness of the treatment provided.

Materials and methods: Retrospective chart analysis of adult at risk and vulnerable patients requiring dental treatment under GA (2007-2017). Outcome variables were indications for GA, DMF/T, and type of treatment, failure rates of treated teeth, emergencies and recall intervals after GA.

Results: Four hundred fourteen subjects (median age 42 years, range 18-93 years) were assigned to four groups (people with disabilities (pwdis), dementias (pwd), dental phobias (pwph), and addictions/psychosocial disorders (pwapd)) and attended the pre-GA assessment. Of these, 247 subjects (median 37 years, range 18-93 years) were treated under GA, mostly pwdis (n = 154, 69.7%). The main indication for treatment under GA was suspicion of pain (n = 178, 72.1%). Pwd had the highest degree of restoration (46.7%), DMF/T value (23.8), and most missing teeth (5.8). Pwapd had the most decayed teeth (12.9). There was a 12-month recall augmented by 2-4 oral hygiene sessions depending on compliance. The failure rate of all treated teeth was 4%. Two dental emergencies were reported for patients who received a GA.

Conclusions: Dental treatment need was high for adult vulnerable people. The diagnostic groups differed mainly in their subjective reason for need of a GA, their DMF/T, treatment needs and type of treatments performed. Failure and dental emergency rates after GA were low in spite of a recall interval of 12 months.

Clinical relevance: Regular annual recalls could avoid dental emergencies in patients requiring treatment under GA.

Keywords: Addiction; Dementia; Dental phobias; Dental treatment; Disabilities; General anaesthesia; Psychiatric disorder.

MeSH terms

  • Adolescent
  • Adult
  • Aftercare
  • Aged
  • Aged, 80 and over
  • Anesthesia, Dental*
  • Anesthesia, General
  • Dental Care
  • Dental Caries*
  • Humans
  • Middle Aged
  • Outpatients
  • Retrospective Studies
  • Young Adult