Department of Child and Public Dental Health, School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland.
School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland.
Spec Care Dentist. 2024 May-Jun;44(3):845-851. doi: 10.1111/scd.12925. Epub 2023 Sep 22.
This paper describes treatments completed under dental general anesthesia (DGA) for a cohort of adults with disabilities. This patient cohort was followed up a number of years later to determine outcomes and identify factors that predict further use of DGA.
A retrospective patient record review and cross-sectional survey was carried out on a convenience sample of 64 patients who had previously received dental treatment under general anesthesia. Patient record review extracted data on patient demographics and treatment provided under DGA. Cross-sectional survey a number of years post-DGA collected data on oral care habits and current oral health based on a standardized clinical examination. Statistical analysis was carried out to identify predictors of repeat DGA.
Participants received extensive treatment under DGA including preventive care, restorations, extractions, and root canal treatment. At follow-up 89.1% of participants had gingival disease and 56.3% had active dental caries. The mean number of teeth present was 21.2 (SD 6.9, range 6-32). Only caries risk status was found to be a significant predictor (p = 0.03) with those with a high caries risk status 6.9 times (95%CI 1.2-39.3) more likely to receive a second DGA.
Dentists extract teeth for people with disabilities under DGA in the mistaken belief that this will avoid the need for further DGA. This study found that extraction of teeth does not prevent the need for repeated episodes of DGA. Therefore, dentists should stop extracting teeth for this reason. Rather, if dentists want to avoid further DGA, they should do the basics well: consistent, evidence-based caries risk assessment and risk reduction.
本文描述了为一组残疾成年人在牙科全身麻醉（DGA）下完成的治疗。这些患者在多年后接受了随访，以确定结果并确定预测进一步使用 DGA 的因素。
对先前接受过全身麻醉下牙科治疗的 64 名患者的便利样本进行了回顾性患者记录回顾和横断面调查。患者记录回顾提取了患者人口统计学和 DGA 下提供的治疗数据。DGA 多年后进行的横断面调查根据标准化临床检查收集了口腔保健习惯和当前口腔健康的数据。进行了统计分析以确定重复 DGA 的预测因素。
参与者在 DGA 下接受了广泛的治疗，包括预防保健、修复、拔牙和根管治疗。在随访时，89.1%的参与者患有牙龈疾病，56.3%有活动性龋齿。存在的平均牙齿数为 21.2（SD 6.9，范围 6-32）。只有龋齿风险状况被发现是一个显著的预测因素（p=0.03），具有高龋齿风险状况的个体接受第二次 DGA 的可能性是 6.9 倍（95%CI 1.2-39.3）。
牙医在 DGA 下为残疾人士拔牙，错误地认为这将避免进一步 DGA 的需要。本研究发现，拔牙并不能预防反复 DGA 的需要。因此，牙医不应出于这个原因拔牙。相反，如果牙医想避免进一步的 DGA，他们应该做好基本工作：一致的、基于证据的龋齿风险评估和风险降低。
