Outpatient, dental care of adult vulnerable patients under general anaesthesia—a retrospective evaluation of need for treatment and dental follow-up care

• Published in: Clinical oral investigations 2021-04, Vol.25 (4), p.2407-2417
• Main Authors: Jockusch, Julia, Hopfenmüller, Werner, Ettinger, Ronald, Nitschke, Ina
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aftercare; Aged; Aged, 80 and over; Anesthesia; Anesthesia, Dental; Anesthesia, General; Dental Care; Dental Caries; Dentistry; Emergencies; Humans; Hygiene; Medicine; Middle Aged; Oral hygiene; Original; Original Article; Outpatients; Patients; People with disabilities; Retrospective Studies; Teeth; Young Adult
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-020-03564-2

Objectives To analyse the treatment needs of patients who had received dental treatment under GA and the effectiveness of the treatment provided. Materials and methods Retrospective chart analysis of adult at risk and vulnerable patients requiring dental treatment under GA (2007–2017). Outcome variables were indications for GA, DMF/T, and type of treatment, failure rates of treated teeth, emergencies and recall intervals after GA. Results Four hundred fourteen subjects (median age 42 years, range 18–93 years) were assigned to four groups (people with disabilities (pwdis), dementias (pwd), dental phobias (pwph), and addictions/psychosocial disorders (pwapd)) and attended the pre-GA assessment. Of these, 247 subjects (median 37 years, range 18–93 years) were treated under GA, mostly pwdis ( n = 154, 69.7%). The main indication for treatment under GA was suspicion of pain ( n = 178, 72.1%). Pwd had the highest degree of restoration (46.7%), DMF/T value (23.8), and most missing teeth (5.8). Pwapd had the most decayed teeth (12.9). There was a 12-month recall augmented by 2–4 oral hygiene sessions depending on compliance. The failure rate of all treated teeth was 4%. Two dental emergencies were reported for patients who received a GA. Conclusions Dental treatment need was high for adult vulnerable people. The diagnostic groups differed mainly in their subjective reason for need of a GA, their DMF/T, treatment needs and type of treatments performed. Failure and dental emergency rates after GA were low in spite of a recall interval of 12 months. Clinical Relevance Regular annual recalls could avoid dental emergencies in patients requiring treatment under GA.