Evaluation of Dental Treatments in Adult Patients with Special Needs: A Retrospective Study

Year 2025, Volume: 35 Issue: 4, 259 - 263, 21.10.2025

Fatih Bedir

https://doi.org/10.17567/currresdentsci.1811567

Abstract

Objective: Patients with special needs are at a higher risk of inadequate oral care, leading to dental caries or periodontal diseases. Therefore, this study aimed to retrospectively analyze the dental records of patients with special needs who received dental treatments under general anesthesia or sedation.
Methods: A total of 186 cases (170 patients) of dental general anesthesia and sedation in adult patients with special needs were included in the study from January 2015 to April 2022. Demographic data, restorative treatments, tooth extractions performed under general anesthesia/sedation, secondary diseases, type of anesthesia, and American Society of Anesthesiologists (ASA) classification were obtained from patient files. Data were recorded as mean ± standard deviation (SD) or numerical value.
Results: Of the 186 cases (mean age 28.55 ± 11.91 years), 134 (72 %) were performed under general anesthesia and 52 (28 %) under sedation. A total of 396 fillings, 775 extractions, 14 root canal treatments, and 93 scaling procedures were performed in 186 cases. On average, each case received 5.5 ± 3.4 teeth fillings, 4.5 ± 4.0 teeth extractions, and 1.6 ± 1.0 root canal treatments. Patients were classified as ASA I (n = 100) at most and ASA III (n = 5) at least.
Conclusion: Patients with special needs have a high demand for dental treatment. In dental treatment of patients with special needs under general anesthesia/sedation, dentists prefer radical treatments such as tooth extraction.

Keywords

Anesthesia , Conscious Sedation , Deep Sedation

Özel Gereksinimli Erişkin Hastalarda Diş Tedavilerinin Değerlendirilmesi: Retrospektif Bir Çalışma

Abstract

ÖZ
Amaç: Özel bakıma ihtiyaç duyan hastalar, diş çürüğü veya periodontal hastalıklara yol açan yetersiz ağız bakımı açısından daha yüksek risk altındadır. Bu çalışma da genel anestezi veya sedasyon altında dental tedavileri yapılan özel bakıma ihtiyaç duyan hastaların dental kayıtlarının retrospektif olarak analiz edilmesi amaçlandı.
Yöntem: Ocak 2015 - Nisan 2022 tarihleri arasında özel bakıma ihtiyaç duyan yetişkin hastalardan dental genel anestezi veya sedasyonla tedavi edilen toplam 186 vaka (170 hasta) çalışmaya dahil edildi. Demografik veriler, restoratif tedaviler, genel anestezi/sedasyon altında yapılan diş çekimleri, sekonder hastalıklar, anestezi tipi ve Amerikan Anestezistler Derneği (ASA) sınıflandırması hasta dosyalarından elde edildi. Veriler ortalama ± standart sapma (SS) veya sayısal değer olarak kaydedildi.
Bulgular: 186 vakanın (ortalama yaş 28,55 ± 11,91 yıl) 134'ü (%72) genel anestezi altında, 52'si (%28) sedasyon altında gerçekleştirilmiştir. 186 vakada toplam 396 dolgu, 775 çekim, 14 kanal tedavisi ve 93 diş taşı temizliği yapılmıştır. Ortalama olarak her vakaya 5,5 ± 3,4 diş dolgusu, 4,5 ± 4,0 diş çekimi ve 1,6 ± 1,0 kök kanal tedavisi uygulanmıştır. Hastalar en fazla ASA I (n = 100) ve en az ASA III (n = 5) olarak sınıflandırılmıştır.
Sonuç: Özel bakıma ihtiyaç duyan hastaların dental tedaviye olan talepleri oldukça yüksektir. Özel gereksinime sahip hastaların genel anestezi/sedasyon altında yapılan dental tedavilerinde diş hekimleri daha çok diş çekimi gibi radikal tedavileri tercih etmektedirler.

Keywords

Anestezi , Bilinçli Sedasyon , Derin Sedasyon

References

• 1. Wang YC, Lin IH, Huang CH, Fan SZ. Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan. 2012;50(3):122-125.
• 2. Martens L, Marks L, Goffin G, Gizani S, Vinckier F, Declerck D. Oral hygiene in 12-year-old disabled children in Flanders, Belgium, related to manual dexterity. Community Dent Oral Epidemiol. 2000;28(1):73-80.
• 3. Nunn JH, Davidson G, Gordon PH, Storrs J. A retrospective review of a service to provide comprehensive dental care under general anesthesia. Spec Care Dentist. 1995;15(3):97-101.
• 4. Shenoy RP, Hegde V, Shenai PK. Dentition status, treatment needs and dental aesthetic index scores of individuals attending special schools. Indian J Community Med. 2011;36(4):301-303.
• 5. Pine DS, Cohen P, Gurley D, Brook J, Ma Y. The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry. 1998;55(1):56-64.
• 6. Schnabl D, Guarda A, Guarda M, von Spreckelsen LMI, Riedmann M, Steiner R, Dumfahrt H. Dental treatment under general anesthesia in adults with special needs at the University Hospital of Dental Prosthetics and Restorative Dentistry of Innsbruck, Austria: a retrospective study of 12 years. Clin Oral Investig. 2019;23(11):4157-4162.
• 7. Çagiran EY, Efeoglu C, Balcioglu T, Koca H. Mental Retarde Hastalarda Dental Tedavi: Retrospektif Inceleme/Dental Treatment in Patients with Mental Retardation: A Retrospective Study. Türkiye Klinikleri Tip Bilimleri Dergisi. 2011;31(4):830.
• 8. Lim M, Borromeo GL. The use of general anesthesia to facilitate dental treatment in adult patients with special needs. J Dent Anesth Pain Med. 2017;17(2):91-103.
• 9. Vargas Román Mdel P, Rodríguez Bermudo S, Machuca Portillo G. Dental treatment under general anesthesia: a useful procedure in the third millennium? (l). Med Oral. 2003;8(2):129-135.
• 10. Stratmann G. Review article: Neurotoxicity of anesthetic drugs in the developing brain. Anesth Analg. 2011;113(5):1170-1179.
• 11. Sun L. Early childhood general anaesthesia exposure and neurocognitive development. Br J Anaesth. 2010;105 Suppl 1(Suppl 1): i61-68.
• 12. Enever GR, Nunn JH, Sheehan JK. A comparison of post-operative morbidity following outpatient dental care under general anaesthesia in paediatric patients with and without disabilities. Int J Paediatr Dent. 2000;10(2):120-125.
• 13. Yang Y, Wang C, Xiang Y, et al. Editorial: Mental Disorders Associated With Neurological Diseases. Front Psychiatry. 2020;11:196.
• 14. GDC General Dental Council: Maintaining Standards 1997: London General Dental Council; 1997.
• 15. Saklad M. Grading of patients for surgical procedures. Anesthesiology. 1941;5:281–284.
• 16. Hurwitz EE, Simon M, Vinta SR, et al. Adding examples to the ASA-physical status classification improves correct assignment to patients. Anesthesiology. 2017;126(4):614-622.
• 17. Fitz-Henry J. The ASA classification and perioperative risk. Ann R Coll Surg. 2011;93:185–187.
• 18. Malmstrom H, Ren Y. Physical Health of Adults with Intellectual Disabilities. In: Prasher VJ eds. Dentition and oral health. Oxford, Blackwell, 2002:181-203.
• 19. Pearlman JS. Dentistry. In: Rubin IC eds. Medical Care for Children and Adults with Developmental Disabilities. Baltimore, Paul H Brookes, 2006;435-449.
• 20. Yagiela J, Neidle E, Dowd F. Pharmacology and Therapeutics for Dentistry. 4th ed. St. Louis, MO, Mosby, 1998.
• 21. Arapovic LL, Karlovic Z, Brzovic VR, et al. Dental Treatment for Special Needs Patients Under General Anaesthesia: A 14-year Experience from South Bosnia and Herzegovina. Acta Med Okayama. 2021;75(3):261-268.
• 22. Berkowitz RJ, Moss M, Billings RJ, Weinstein P. Clinical outcomes for nursing caries treated using general anesthesia. ASDC J Dent Child. 1997;64(3):210-211, 228.
• 23. de Nova García MJ, Gallardo López NE, Martín Sanjuán C, Mourelle Martínez MR, Alonso García Y, Carracedo Cabaleiro E. Criteria for selecting children with special needs for dental treatment under general anaesthesia. Med Oral Patol Oral Cir Bucal. 2007;12(7):E496-503.
• 24. Mitchell L, Murray JJ. Management of the handicapped and the anxious child: a retrospective study of dental treatment carried out under general anaesthesia. J Paediatr Dent. 1985;1(1):9-14.
• 25. Mallineni SK, Yiu CKY. A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period. J Clin Pediatr Dent. 2018;42(2):155-160.
• 26. Savanheimo N, Sundberg SA, Virtanen JI, Vehkalahti MM. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service. BMC Oral Health. 2012;12:45.
• 27. Ali S, Sims C, Foy S, McIndoe A, Yates R, Brooke T. A review of daycase GA services for Special Care patients at University Hospital, Bristol. Community Dent Health. 2016;33(1):6-8.
• 28. Keyes PH, Rams TE. Dental Calculus Arrest of Dental Caries. J Oral Biol (Northborough). 2016;3(1).
• 29. Yılmaz Z, Işık B. A retrospective analysis of dental procedures performed under general anesthesia. J Anest. 2016;24(2):84-89.
• 30. Baird WO, McGrother C, Abrams KR, Dugmore C, Jackson RJ. Access to dental services for people with a physical disability: a survey of general dental practitioners in Leicestershire, UK. Community Dent Health. 2008;25(4):248-252.
• 31. Kries T, Rupf S, Hannig M, et al. The impact of general medical health status, demographical, and patient-specific variables on need for dental treatment of children and adolescents under general anesthesia. Clin Oral Invest. 2023;27:4245–4257.
• 32. Abdo M, Al Halabi M, Hussein I, et al. Characteristics of Pediatric Dental Treatment Provided under General Anesthesia in Dubai, United Arab Emirates: A Retrospective Analysis. Int J Dent. 2022;1-8.
• 33. Linas N, Faulks D, Hennequin M, et al. Conservative and endodontic treatment performed under general anesthesia: A discussion of protocols and outcomes. Spec Care Dentist. 2019;39(5):453-463.
• 34. Biasotto M, Poropat A,, Porrelli D, et al. Dental Treatment in Special Needs Patients and Uncooperative Young Children: A Retrospective Study. Medicina. 2024;60(1):91.
• 35. Turjanski S, Musić L, Špiljak B, et al. Analysis of Hospital-Based Dental Procedures Under General Anesthesia in Uncooperative Patients: a Retrospective Study. Acta Stomatol Croat. 2023;57(1):22-31.