Which one is the most preferred anesthesia type in dental treatments of patients with special needs: sedation or general anesthesia?

Abstract

Aim: Patients with special needs, who have mental, physical or medical disabilities, were reported to have worse oral hygiene than their healthy peers. Disabled patients are usually uncooperated, and dental treatments of these patients are completed under several anesthesia types. Our aim was to compare anesthesia types in dental treatments of patients with special needs. Material and Method: The study included review of uncooperated patients, who had physical or mental disabilities, between June 1, 2021 and June 1, 2022. Patients were divided into three groups due to their anesthesia types; sedation (Group S), laryngeal mask airway (LMA) (Group L), and nasotracheal intubation (Group N). Results: In total 80 patients were analyzed; 4 patients excluded, 45 patients were in Group S, 19 patients were in Group L, and 12 patients were in Group N. Anesthesia times were significantly different between groups; 20 min in Group S, 25 min in Group L, and 45 min in Group N. Propofol use was significantly low (p<0.001) and ketamine use was significantly high in Group S (p=0.002). Number of tooth extractions was not significantly different between groups, but number of filling tooth was significantly high in Group N (p=0.002). Conclusion: Sedation was the most preferred anesthesia type in dental treatment of patients with special needs. Although all three types of anesthesia can be used safely in dental treatments, we suggest that sedation can be considered as the first choice in tooth extraction in patients deemed appropriate by the anesthesiologist and dentist.