University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Clin Oral Investig. 2019 Nov;23(11):4157-4162. doi: 10.1007/s00784-019-02854-8. Epub 2019 Mar 4.
Special needs patients are prone to insufficient oral care and subsequent caries or periodontitis. The aim of this retrospective study was the assessment of demand for restorative therapy and tooth extractions under general anesthesia in adults with intellectual and/or physical disablement (IPD) or psychiatric disorders (PDs) with inherent dentist phobia at the University Hospital of Innsbruck with regard to demographic factors.
A total of 444 consecutive cases of scheduled dental general anesthesia (DGA) in adults from 2003 to 2014 were included. From patient files, demographic data, the presence of either IPD or a PD, attested by a mandatory certificate, and restorative therapy and tooth extractions performed under DGA were obtained. Data analysis was carried out by means of descriptive and comparative statistics.
Four hundred two cases (mean age 37.5 ± 13.87 years) assigned to 283 individuals with IPD and 42 cases (mean age 36.09 ± 13.03 years) assigned to 39 individuals with PDs arose in the observed period. Patients with PDs required significantly more restorations (in 7.98 ± 5.4 versus 5.34 ± 4.41 teeth; p = 0.002; Mann-Whitney U test) and extractions (of 4.86 ± 4.51 versus 2.6 ± 3.96 teeth; p < 0.001; Mann-Whitney U test) than patients with IPD.
Demand for dental treatment was high in the collective of special needs patients. Oral health status was worse in patients with PDs than in patients suffering IPD.
While in patients with severe disablement, DGA presents the only treatment option, specific preventive programs should be implemented for patients with minor disablement or dentist phobia. In these patients, alternative approaches should be promoted.
特殊需求患者往往口腔护理不足，随后会出现龋齿或牙周炎。本回顾性研究的目的是评估因内在牙医恐惧症而在因智力和/或身体残疾（IPD）或精神障碍（PD）接受牙科全麻（DGA）的成年人中，在因斯布鲁克大学医院，对修复治疗和拔牙的需求，这与人口统计学因素有关。
共纳入 2003 年至 2014 年期间 444 例接受牙科全麻的成年人连续病例。从患者档案中获取人口统计学数据、是否存在 IPD 或 PD 的情况（由强制性证书证明），以及在 DGA 下进行的修复治疗和拔牙情况。数据分析采用描述性和比较性统计方法。
在观察期间，402 例（平均年龄 37.5±13.87 岁）病例分配给 283 名 IPD 患者，42 例（平均年龄 36.09±13.03 岁）病例分配给 39 名 PD 患者。PD 患者需要更多的修复（分别为 7.98±5.4 颗和 5.34±4.41 颗；p=0.002；Mann-Whitney U 检验）和拔牙（分别为 4.86±4.51 颗和 2.6±3.96 颗；p<0.001；Mann-Whitney U 检验）。
特殊需求患者对牙科治疗的需求很高。PD 患者的口腔健康状况比 IPD 患者差。
虽然在严重残疾患者中，DGA 是唯一的治疗选择，但应针对轻度残疾或牙医恐惧症患者实施特定的预防计划。在这些患者中，应推广替代方法。
