Dziedzic Arkadiusz
SAAD Dig. 2017;33:48-54.
Dental practitioners dealing with children and individuals with special needs can be supported by the provision of general anaesthesia for the most challenging patients in situations where other options are insufficient. The availability of general anaesthesia will further the aim of extending access to the widest range of dental care to the greatest number of patients regardless of disability, age or phobia. The objective is to ensure patients have a pain-free and healthy mouth, and any necessary treatment in the most appropriate setting related to their specific needs. A strictly individual and holistic approach is required when evaluating the risk versus benefit of proceeding with general anaesthesia for delivery of dental treatment particularly for children and special needs individuals. It is vitally important to consider and address all relevant factors specific to this particular group of patients including assessment of capacity, validity of consent, and any specific medical, social and behavioural issues. The other sedation modalities must be always taken into consideration. This article emphasises the crucial decision-making role of dentists in the referral process for dental treatment under general anaesthesia and the need for multidisciplinary co-operation between dental practitioners, community and hospital services.
对于儿童和有特殊需求的患者,当其他选择不足以应对最具挑战性的患者时,可为牙科从业者提供全身麻醉支持。全身麻醉的可及性将推动实现以下目标:使无论残疾、年龄或恐惧症情况如何的最多患者能够获得最广泛的牙科护理。目标是确保患者拥有无痛且健康的口腔,并在与其特定需求相关的最合适环境中接受任何必要治疗。在评估为儿童和有特殊需求的个体进行牙科治疗而实施全身麻醉的风险与益处时,需要采取严格的个体化和整体化方法。至关重要的是要考虑并解决该特定患者群体的所有相关因素,包括能力评估﹑同意的有效性以及任何特定的医疗、社会和行为问题。还必须始终考虑其他镇静方式。本文强调了牙医在全身麻醉下牙科治疗转诊过程中的关键决策作用,以及牙科从业者、社区和医院服务之间多学科合作的必要性。