Dental Extraction under GA among Disabled Patients

A new study published in the Special Care in Dentistry suggests that dental extraction under general anesthesia (GA) among disabled patients does not prevent the need for repeated episodes of dental general anesthesia (DGA).

Study Overview

This paper describes treatments completed under 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.

Methodology

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. A cross-sectional survey conducted 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
• 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.

Conclusion

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