Dental extraction under GA among disabled patients does not prevent need for repeated episodes of DGA

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.

Results

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.

Reference:

McGeown, D, Mac Giolla Phadraig, C, Van Harten, M, Stapleton, S, Nunn, J. Dental extractions do not predict further use of dental general anesthesia in people with disabilities: A longitudinal analysis. Spec Care Dentist. 2023; 1-7. https://doi.org/10.1111/scd.12925

Keywords:

Dental, extraction, under, GA, among, disabled, patients, prevent, need, repeated, episodes, DGA, McGeown, D, Mac Giolla Phadraig, C, Van Harten, M, Stapleton, S, Nunn, J, Special care in dentistry