Dental Care Under General Anesthesia for Individuals with Disabilities: Challenges in Children and Adults
TL;DR
Dental treatment needs under GA varied by age group, with a more comprehensive and complex treatment burden emerging among adults, and improvement of preventive applications and easily accessible dental care are the main domains for developing oral health policies for patients with disabilities.
Abstract
AbstractAim: The high prevalence of oral health problems and barriers to dental healthcare access constitute an important health inequity for individuals with disabilities. This inequity becomes more pronounced in patients who cannot be treated in standard clinical settings and require general anesthesia (GA) for comprehensive dental care. This study aimed to evaluate the sociodemographic and clinical profiles, treatment needs, and service process indicators of children and adults with disabilities who received dental health services under GA at a faculty of dentistry.Methods: This retrospective study analyzed Hospital Information Management System (HIMS) records of 262 patients with disabilities who received dental health services under GA between March 2017 and March 2020. Evaluated variables included GA sessions, waiting times, operation durations, medical consultation requirements, referral status, out-of-pocket payment status, and dental treatment needs. Descriptive statistics, Chi-square, and Mann–Whitney U tests were performed. Results: Of the patients, 38.2% were children and 61.8% were adults. Their main diagnosis were neurodevelopmental disorders, diseases of the nervous system, and developmental anomalies. The presence of out-of-pocket payments (Children [C]: 11.0%; Adults [A]: 38.9%; p=0.000) and the rate of receiving multiple GA sessions (C: 1.0%; A: 22.2%; p=0.000) were higher in adults. Additionally, the duration of the first GA session was significantly longer in adults (C: 170 min; A: 195 min; p=0.039). The most common dental treatment needs under GA were restorative (91.0%) and surgical (88.0%) treatments in children, and periodontal (90.1%), restorative (87.2%), and surgical (66.0%) treatments in adults.Conclusion: Dental treatment needs under GA varied by age group, with a more comprehensive and complex treatment burden emerging among adults. Therefore, improvement of preventive applications and easily accessible dental care are the main domains for developing oral health policies for patients with disabilities.Keywords: Dental care for persons with disabilities, General anesthesia, Treatment needs, Health services accessibility, Hospital information management systems