ÇOCUK DİŞ HEKİMLİĞİNDE GENEL ANESTEZİ

Year 2022, Volume: 9 Issue: 2, 696 - 705, 24.08.2022

Büşra Karaduran Sezen Kumaş Solak Mine Koruyucu

https://doi.org/10.15311/selcukdentj.961790

Abstract

Diş çürükleri çocuklarda oldukça yaygın görülen ve genel sağlığı olumsuz yönde etkileyebilen kronik bir hastalıktır. Çocuklarda ağrıya, beslenme problemleri gibi genel sağlık sorunlarına ve psikolojik problemlere yol açabilmektedir; bu nedenle tedavi edilmeleri gerekmektedir. Her çocuk, rutin bir şekilde klinik ortamında tedavi edilemeyebilmekte ve ekstra davranış yönlendirme tekniklerine ihtiyaç duyulabilmektedir. Koopere olmayan ve engelli çocukların dental tedavileri uygun ve gerekli endikasyon değerlendirmesi yapıldıktan ve oluşabilecek komplikasyonlar ile yarar-zarar ilişkisi değerlendirildikten sonra ileri davranış yönlendirme tekniklerinden olan genel anestezi ile tedavi edilebilmektedir. Genel anestezi altında dental tedavinin yapılması kararının verilmesinden önce sedasyon dahil olmak üzere tüm olası alternatif tedavi yolları değerlendirilmeli ve aile bu konu hakkında detaylı şekilde bilgilendirilmelidir. Diş hekimleri genel anestezi uygulamasının endikasyonları, kontraendikasyonları ve komplikasyonları hakkında detaylı bilgiye sahip olmalıdır; anestezi uzmanları ile işbirliği içerisinde olmalıdır. Hastaların tedavi öncesinde detaylı bir şekilde genel sağlık durumunun ve ağız sağlığının değerlendirilmesi, hastaların tedavi planlamasının yapılması gerekmektedir. Böylece hastaya özel tedavi yaklaşımı ile oluşabilecek komplikasyonların ve ileride tekrarlayabilecek tedavi gereksinimlerinin önüne geçilebilmesi mümkün olabilmektedir. Genel anestezi altında gerçekleştirilen dental tedavilerin başarı oranı uygulanan tedavi prosedürüne, tercih edilen restoratif materyale, tedavi sonrasındaki oral hijyen alışkanlıklarına ve hastanın diyet özelliklerine bağlı olabilmektedir. Önemli olan hastaya kalıcı oral hijyen alışkanlığının kazandırılması ve geleceğe yönelik olumlu davranışların oluşmasını sağlayabilmektir.

Keywords

Çocuk, dental tedavi, genel anestezi

GENERAL ANESTHESIA IN PEDIATRIC DENTISTRY

Abstract

Dental caries is a chronic disease that is very common in children and it can negatively affect general health. It can cause pain, general health problems such as nutritional problems and psychological problems in children; therefore they need to be treated. Not all children can be treated routinely in the clinical setting and additional behavior management techniques may be needed. Dental care of uncooperative and disabled children can be treated under general anesthesia, which is one of the advanced behavior management techniques, after appropriate and necessary indications are evaluated and complications that may occur and the benefit-harm relationship are evaluated. Before making the decision to perform dental care under general anesthesia, all possible alternative routes including sedation should be evaluated and the family should be informed in detail about this issue. Dentists should have detailed information about the indications, contraindications and complications of general anesthesia. Dentists should cooperate with anesthesiologists. Patients should be evaluated their general health and oral health in detail before treatment, and should be planned for treatment. Thus, it is possible to prevent complications and the need for recurrent treatment in the future that may occur with a patient-specific treatment approach. The success rate of dental care performed under general anesthesia may depend on the treatment procedure applied, the preferred restorative material, the oral hygiene habits after the treatment and the dietary characteristics of the patient. The important thing is that the patient has a permanent oral hygiene habit.

Keywords

Child, dental care, general anesthesia

References

• Referans1 World Health Organization. Oral Health [Internet]. WHO [June 17, 2019]. https://www.who.int/news-room/fact-sheets/detail/oral-health
• Referans2 Pitts NB, Zero DT, Marsh PD, Ekstrand K, Weintraub JA, Ramos-Gomez F, et al. Dental caries. Nat Rev Dis Primers. 2017;3:17030.
• Referans3 Montero J, Rosel E, Barrios R, López-Valverde A, Albaladejo A, Bravo M. Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain. Int J Paediatr Dent. 2016;26(3):220-230.
• Referans4 Bönecker M, Abanto J, Tello G, Oliveira LB. Impact of dental caries on preschool children's quality of life: an update. Braz Oral Res. 2012;26(1):103-107.
• Referans5 Psoter WJ, Reid BC, Katz RV. Malnutrition and dental caries: a review of the literature. Caries Res. 2005;39(6):441-447.
• Referans6 Schroth RJ, Levi J, Kliewer E, Friel J, Moffat MEK. Association between iron status, iron deficiency anaemia, and severe early childhood caries: a case–control study. BMC Pediatr. 2013;13(22):2-7.
• Referans7 American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2020;292-310.
• Referans8 National Maternal and Child Oral Health Resource Center. 2018. Special Care: An Oral Health Professional’s Guide to Serving Young Children with Special Health Care Needs, 2nd ed. Washington, D.C.: National Maternal and Child Oral Health Resource Center.
• Referans9 Kşucu ÖÖ, Akyuz S. Children's preferences concerning the physical appearance of dental injectors. Journal of Dentistry for Children 2006;73(2):116-121.
• Referans10 Stigers JI. Nonpharmacologic management of children’s behaviors. In: Dean JA, ed. McDonald and Avery’s Dentistry for the Child and Adolescent. 10th ed. St. Louis, Mo.: Elsevier. 2016;286-302.
• Referans11 European Archives of Paediatric Dentistry. Management problems in paediatric dentistry—a review of background factors and diagnostics. 2008;9(1):11-15.
• Referans12 American Academy of Pediatric Dentistry. Use of anesthesia providers in the administration of office-based deep sedation/ general anesthesia to the Pediatric Dental Patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2020:358-361.
• Referans13 Ozler CO, Keceli TI, Tekcıcek MU. Çocuk Diş Hekimliği ve Genel Anestezi. Ankara Med J. 2019;(3):658-664.
• Referans14 American Dental Assosication. Guidelines for the Use of Sedation and General Anesthesia by Dentists [Internet]. ADA [October, 2016]. https://www.ada.org/~/media/ADA/Education%20and%20Careers/Files/anesthesia_use_guidelines.pdf
• Referans15 American Society of Anesthesiologists. ASA Physical Status Classification System [Internet]. ASA [December 13, 2020]. https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system
• Referans16 American Society of Dentist Anesthesiologists: Parameters of Care. Anesth Prog. 2018;65(3):197-203.
• Referans17 Yılmaz M, Türer A, Sümer M. Diş Hekimliği Pratiğinde Genel Anestezi: Derleme. Duzce Medical Journal. 2013;15(1):68-72.
• Referans18 Akpinar H. Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study. J Dent Anesth Pain Med. 2019;19(4):191-199.
• Referans19 Elo JA, Sun HH. Anesthesia and Sedation. A Textbook of Advanced Oral and Maxillofacial Surgery Volume 3; 2016. doi:10.5772/63539.
• Referans20 Coté CJ, Wilson S. American Academy of Pediatric Dentistry, American Academy of Pediatrics. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures. Pediatr Dent 2019;41(4):E26-E52.
• Referans21 Broscheit J, Kranke P. Charakteristika und Auswahl der Substanzen [The preoperative medication: background and specific indications for the selection of the drugs]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2008;43(2):134-143.
• Referans22 Ramazani N. Different Aspects of General Anesthesia in Pediatric Dentistry: A Review. Iran J Pediatr. 2016;26(2):e2613.
• Referans23 Türk A nesteziyoloji ve Reaminasyon Derneği. Genel Anestezi [İnternet]. TARD AKADEMİ [2016]. http://www.tard.org.tr/akademi/?p=detail&bID=1&capt=2&sub=1&session=10775717744028-21551435488056
• Referans24 Silva A, Stoelting R, Miller R. Anesthetic monitoring: Basic Of Anesthesia, 5th Ed., Philadelphia, Churchill Livingstone, Elsevier 2007; 305-316.
• Referans25 Siddiqui BA, Kim PY. Anesthesia Stages. 2021 Mar 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.
• Referans26 Townsend JA, Hagan JL, Smiley M. Use of local anesthesia during dental rehabilitation with general anesthesia: a survey of dentist anesthesiologists. Anesth Prog. 2014;61(1):11-17.
• Referans27 Dean JA, Jones JE, Vinson LAW, Preceded by : McDonald RE. McDonald and Avery’s Dentistry for the Child and Adolescent . Tenth edition. Elsevier; 2016.
• Referans28 Koch G, Poulsen S, Espelid I, Haubek D. Pediatric Dentistry: A Clinical Approach, 3rd edition. Wiley; 2017 January.
• Referans29 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(1):45
• Referans30 Stratmann G: Review article: Neurotoxicity of anesthetic drugs in the developing brain. Anesth Analg 2011;113:1170–1179.
• Referans31 Sun L. Early childhood general anaesthesia exposure and neurocognitive development. Br J Anaesth. 2010;105:(1):i61-68.
• Referans32 Ganzberg S. The FDA Warning on Anesthesia Drugs. Anesth Prog. 2017;64:57-58.
• Referans33 Food and Drug Administration. FDA approves label changes for use of general anesthetic and sedation drugs in young children [Internet]. FDA [April 27, 2017]. https://www.fda.gov/media/104705/download
• Referans34 Food and Drug Administration. FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women (Internet). FDA [December 14, 2016]. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and
• Referans35 Campbell RL, Shetty NS, Shetty KS, Pope HL, Campbell JR. Pediatric Dental Surgery Under General Anesthesia: Uncooperative Children. Anesth Prog. 2018;65:225-230.
• Referans36 Liu X, Ji J, Zhao GQ. General anesthesia affecting on developing brain: evidence from animal to clinical research. J Anesth. 2020;34(5):765-772.
• Referans37 Grabowski J, Goldin A, Arthur LG, Beres AL, Guner YS, Hu YY, et al. The effects of early anesthesia on neurodevelopment: A systematic review. J Pediatr Surg. 2021;56(5):851-861.
• Referans38 Zhou P, Zhang C, Huang G, Hu Y, Ma W, Yu C. The effect of sevoflurane anesthesia for dental procedure on neurocognition in children: a prospective, equivalence, controlled trial. BMC Pediatr. 2021;21(1):177.
• Referans39 National Health Service. General Anesthesia [Internet]. NHS [April 23, 2018]. https://www.nhs.uk/conditions/general-anaesthesia/
• Referans40 Boynes SG, Moore PA, Lewis CL, Zovko J, Close JM. Complications associated with anesthesia administration for dental treatment in a special needs clinic. Special Care in Dentistry. 2010;30(1):3-7.
• Referans41 Islam S, Selbong U, Taylor CJ, Ormiston IW. Does a patient's Mallampati score predict outcome after maxillomandibular advancement for obstructive sleep apnoea? Br J Oral Maxillofac Surg. 2015;53(1):23-27.
• Referans42 Kumar S, Verma N, Agarwal A. Lingual tonsillar hypertrophy: Cause of un-anticipated difficult intubation. J Anaesthesiol Clin Pharmacol. 2014;30(4):590-591.
• Referans43 Kannikeswaran N, Mahajan PV, Sethuraman U, Groebe A, Chen X. Sedation medication received and adverse events related to sedation for brain MRI in children with and without developmental disabilities. Paediatr Anaesth. 2009;19:250-256.
• Referans44 Hung WT, Hsu SC, Kao CT. General anesthesia for developmentally disabled dental care patients: a comparison of reinforced laryngeal mask airway and endotracheal intubation anesthesia. Spec Care Dentist. 2003;23(4):135-138.
• Referans45 Chen XX, Jiang X, Zhong J, Zhang HM, Huang Q, Xia B. [Postoperative complications following dental rehabilitation under general anesthesia in children]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2017;52(11):661-666.
• Referans46 Doh RM. Foreign body aspiration during dental treatment under general anesthesia: A case report. J Dent Anesth Pain Med. 2019;19(2):119-123.
• Referans47 Mortazavi H, Baharvand M, Safi Y. Death Rate of Dental Anaesthesia. J Clin Diagn Res. 2017;11(6):ZE07-ZE09.
• Referans48 Lee HH, Milgrom P, Starks H, Burke W. Trends in death associated with pediatric dental sedation and general anesthesia. Paediatr Anaesth. 2013;23(8):741-746.
• Referans49 Roberts GJ, Mokhtar SM, Lucas VS, Mason C. Deaths associated with GA for dentistry 1948 - 2016: the evolution of a policy for general anaesthesia (GA) for dental treatment. Heliyon. 2020;6(1):e02671.
• Referans50 Türk Dişhekimleri Birliği. Ağız ve diş sağlığı hizmeti sunulan özel sağlık kuruluşları hakkında yönetmelik [İnternet]. TDB [11 Kasım, 2017]. http://www.tdb.org.tr/mevzuat_goster.php?Id=97
• Referans51 Wang YC, Lin IH, Huang CH, Fan SZ. Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan. 2012;50(3):122-125.
• Referans52 El-Mowafy A, Yarascavitch C, Haji H, Quiñonez C, Haas DA. Mortality and Morbidity in Office-Based General Anesthesia for Dentistry in Ontario. Anesth Prog. 2019;66(3):141-150.
• Referans53 Spera AL, Saxen MA, Yepes JF, Jones JE, Sanders BJ. Office-Based Anesthesia: Safety and Outcomes in Pediatric Dental Patients. Anesth Prog. 2017;64(3):144-152.