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General anaesthesia in special care dentistry: Part 3. case series Xin Hui Yeo Daniel Gillway Ahmed Kahatab Mili Doshi Zahra Shehabi Andrew Geddis-Regan Dental Update 2025 52:2, 93-102.
Authors
Xin HuiYeo
BDS, MSc (Dental Implantology), DipConSed, MFDS RCPS(Glasg), PgCert Dent Ed, CiLT, AKC, MSCD, StR Special Care Dentistry, Barts's Health NHS Trust, London
BSc (Hons), BChD, DSCD RCS Eng, MSCD RCS Ed, PhD, Consultant in Special Care Dentistry, University Dental Hospital of Manchester; Honorary Senior Lecturer in Dentistry, University of Manchester
General anaesthesia is frequently used to provide comprehensive dental care to the varied groups of patients treated in special care dentistry services, as discussed in Parts 1 and 2 of this case series. General anaesthesia provision also offers an opportunity for multidisciplinary team working to support holistic patient care, particularly if investigations are difficult, impossible or compromised owing to patient factors. Thorough patient assessment and consideration, as well as a collaborative approach between the different teams, are required for successful patient-centred care. Reasonable adjustments are often crucial for special care patients, requiring thoughtful planning and consideration from admission to safe discharge. This article presents five case examples of the use of general anaesthesia to provide dental care in complex circumstances.
CPD/Clinical Relevance: Examples are presented of how the use of general anaesthesia in special care dentistry requires careful consideration and planning.
Article
Pharmacological intervention is often needed to facilitate the safe delivery of quality dental care for patients in special care dentistry, in particular for patients with moderate to severe learning disabilities, autistic spectrum disorder and dental phobia with complex treatment needs. By inducing a loss of consciousness, general anaesthesia (GA) is inherently more invasive and restrictive than other approaches for dental care provision.1 While it is often used when less restrictive options have been attempted but failed,2 sometimes it is the only feasible approach to provide care, or is felt to be the safest and most appropriate care modality despite its medical and psychosocial implications.3 Parts 1 and 2 of this series detail the planning and delivery of GA in special care dentistry, respectively. In the final part of the series, case examples demonstrate the importance of case selection, preparation, flexibility and teamwork to enable patient-centred care to be undertaken safely and effectively.
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