Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Cross-Sectional Analysis of Dental Treatment Procedures Performed Under General Anesthesia or Sedation
Genel Anestezi veya Sedasyon Altında Yapılan Diş Tedavi Prosedürlerinin Kesitsel Analizi
Hilal ZENGİNa, Necdet İMAÇb
aClinic of Anesthesia and Reanimation, Tepebaşı Oral and Dental Health Hospital, Ankara, Türkiye
bClinic of Dendistry, Tepebaşı Oral and Dental Health Hospital, Ankara, Türkiye
Turkiye Klinikleri J Anest Reanim. 2023;21(1):17-27
doi: 10.5336/anesthe.2022-94992
Article Language: EN
Full Text
ABSTRACT
 Objective: Although dental procedures can be performed under local anesthesia, some special cases may require general anesthesia (GA) or sedoanalgesia (SA). We aimed to investigate and compare the data of patients who underwent dental procedures under GA or SA. Material and Methods: The data of patients who underwent dental treatment under GA and SA in the dental hospital between 2012 and 2014 were analyzed. Demographic data and American Society of Anesthesiology scores duration of dental treatment, type of treatment (extraction, root canal, filling, amputation, extraction, cyst excision), number of procedures (i.e. single or multiple dental procedures), mental health status, muscle relaxant additional data, including use and opioid use, were obtained from anesthesia document. The patients were divided into groups according to the anesthesia method used (i.e. GA or SA). The data of healthy and mentally retarded individuals were also compared within the GA and SA groups. Results: The entire cohort included 896 patients. The mean patient age was 8.4+/-8.1 and 8.7+/-8.7 in the GA (n=596) and SA (n=300) groups, respectively. The mean procedure time was 70 (15-175) and 20 (5-50) minutes in the GA and SA groups. The rate of mentally healthy patients in SA was significantly higher than in the GA group (p<0.001). The rate of multiple procedures was significantly higher in the GA group than in the SA group (p<0.001). Conclusion: SA can be performed in short dental procedures provided the patency of the airway is maintained. GA may be preferred in mentally retarded and healthy patients in multiple dental procedures.

Keywords: Dental anxiety; general anesthesia; sedoanalgesia
ÖZET
 Amaç: Dental işlemler lokal anestezi altında yapılabilse de bazı özel durumlarda genel anestezi (GA) veya sedoanaljezi (SA) gerektirebilir. Bu çalışmamızda, GA veya SA altında dental prosedür uygulanan hastaların verilerini araştırmayı amaçladık. Gereç ve Yöntemler: 2012-2014 yılları arasında bir diş hastanesinde GA ve SA altında dental tedavi uygulanan hastaların verileri incelendi. Demografik veriler, ''American Society of Anesthesiology''skorları diş tedavi süresi, tedavi türleri (çekim, kanal, dolgu, ampütasyon, detertraj, kist eksizyonu ve diğer işlemler), prosedür sayısı (tek veya çoklu diş işlemi), zihinsel sağlık durumu, kas gevşetici ve opioid kullanımı dâhil olmak üzere ek veriler anestezi fişlerinden alındı. Hastalar kullanılan anestezi yöntemine göre (GA veya SA) gruplara ayrıldı. GA ve SA grupları içinde de sağlıklı ve zihinsel engelli bireylerin verileri karşılaştırıldı. Bulgular: Tüm kohort 896 hastayı içeriyordu. Ortalama hasta yaşı GA (n=596) ve SA (n=300) gruplarında sırasıyla 8,4+/-8,1ve 8,7+/-8,7 idi. GA ve SA gruplarında ortalama işlem süresi 70 (15-175) ve 20 (5-50) dk idi. SA'da mental olarak sağlıklı hasta oranı GA grubuna göre anlamlı derecede yüksekti (p<0,001). Çoklu işlem oranı GA grubunda SA grubuna göre anlamlı derecede yüksekti (p<0,001). Sonuç: SA, havayolunun açıklığının korunması şartıyla kısa diş prosedürlerinde yapılabilir. Çoklu dental işlemlerde, zihinsel engelli ve sağlıklı hastalarda GA tercih edilebilir.

Anahtar Kelimeler: Dental anksiyete; genel anestezi; sedoanaljezi
REFERENCES:
  1. Ahuja R, Jyoti B, Shewale V, Shetty S, Subudhi SK, Kaur M. Comparative evaluation of pediatric patients with mental retardation undergoing dental treatment under general anesthesia: a retrospective analysis. J Contemp Dent Pract. 2016;17(8):675-8. [Crossref]  [PubMed] 
  2. Jaakkola S, Rautava P, Alanen P, Aromaa M, Pienihäkkinen K, Räihä H, et al. Dental fear: one single clinical question for measurement. Open Dent J. 2009;3:161-6. [Crossref]  [PubMed]  [PMC] 
  3. Guney SE, Araz C, Tirali RE, Cehreli SB. Dental anxiety and oral health-related quality of life in children following dental rehabilitation under general anesthesia or intravenous sedation: A prospective cross-sectional study. Niger J Clin Pract. 2018;21(10):1304-10. [PubMed] 
  4. Bennett JD, Kramer KJ, Bosack RC. How safe is deep sedation or general anesthesia while providing dental care? J Am Dent Assoc. 2015;146(9):705-8. [Crossref]  [PubMed] 
  5. Wang YC, Lin IH, Huang CH, Fan SZ. Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan. 2012;50(3):122-5. [Crossref]  [PubMed] 
  6. Behavior Guidance for the Pediatric Dental Patient. Pediatr Dent. 2018;40(6):254-67. [PubMed] 
  7. 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. [Crossref]  [PubMed]  [PMC] 
  8. Davidson AJ, Sun LS. Clinical evidence for any effect of anesthesia on the developing brain. Anesthesiology. 2018;128(4):840-53. [Crossref]  [PubMed] 
  9. Messieha Z, Ananda RC, Hoffman I, Hoffman W. Five year outcomes study of dental rehabilitation conducted under general anesthesia for special needs patients. Anesth Prog. 2007;54(4):170-4. [Crossref]  [PubMed]  [PMC] 
  10. Fiorillo L. Conscious sedation in dentistry. Medicina (Kaunas). 2019;55(12):778. [Crossref]  [PubMed]  [PMC] 
  11. Rosenberg M; American Dental Association. New guidelines for the use and teaching of general anesthesia and sedation by dentists. J Mass Dent Soc. 2010;58(4):22-7. [PubMed] 
  12. Dougherty N. The dental patient with special needs: a review of indications for treatment under general anesthesia. Spec Care Dentist. 2009;29(1):17-20. [Crossref]  [PubMed] 
  13. Lim MAWT, 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. [Crossref]  [PubMed]  [PMC] 
  14. Ohtawa Y, Tsujino K, Kubo S, Ikeda M. Dental treatment for patients with physical or mental disability under general anesthesia at Tokyo Dental College Suidobashi Hospital. Bull Tokyo Dent Coll. 2012;53(4):181-7. [Crossref]  [PubMed] 
  15. Sitkin SI, Gasparian AL, Ivanova TI, Nesterova EI, Drozdova NI. [Long-term dental interventions in mentally retarded children under general anesthesia with sevoflurane]. Stomatologiia (Mosk). 2015;94(1):59-60. Russian. [Crossref]  [PubMed] 
  16. Schnabl D, Guarda A, Guarda M, von Spreckelsen LMI, Riedmann M, Steiner R, et al. 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):4157-62. [Crossref]  [PubMed] 
  17. Campbell RL, Shetty NS, Shetty KS, Pope HL, Campbell JR. Pediatric dental surgery under general anesthesia: uncooperative children. Anesth Prog. 2018;65(4):225-30. [Crossref]  [PubMed]  [PMC] 
  18. Miller R, Eriksson L, Fleisher L, Wiener-Kronish J, Young W. Miller's Anesthesia. 7th ed. Philadelphia: Churchill Livingstone/Elsevier; 2009.
  19. Özkan AS, Erdoğan MA, Şanlı M, Kaçmaz O, Durmuş M, Çolak C. Retrospective evaluation of dental treatment under general anaesthesia. Turk J Anaesthesiol Reanim. 2015;43(5):332-6. [Crossref]  [PubMed]  [PMC] 
  20. Wheeler DS, Vaux KK, Ponaman ML, Poss BW. The safe and effective use of propofol sedation in children undergoing diagnostic and therapeutic procedures: experience in a pediatric ICU and a review of the literature. Pediatr Emerg Care. 2003;19(6):385-92. [Crossref]  [PubMed] 
  21. Messieha Z, Cruz-Gonzalez W, Hakim MI. Retrospective outcomes evaluation of 100 parenteral moderate and deep sedations conducted in a general practice dental residency. Anesth Prog. 2008;55(4):116-20. [Crossref]  [PubMed]  [PMC] 
  22. Özmert S, Kavak Akelma F, Ökten ZC. Derin sedasyon altında dental tedavi uygulanan çocuklarda anestezik yaklaşımın değerlendirilmesi [Evaluation of the anesthetic approach in children for dental treatment under deep sedation]. Türkiye Çocuk Hast Derg/Turkish J Pediatr Dis. 2019;13(1):30-5. [Link] 
  23. Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail's Clinical Anesthesiology. 6th ed. New York: McGraw Hill; 2018.
  24. Mishu MP, Faisal MR, Macnamara A, Sabbah W, Peckham E, Newbronner L, et al. A Qualitative study exploring the barriers and facilitators for maintaining oral health and using dental service in people with severe mental illness: perspectives from service users and service providers. Int J Environ Res Public Health. 2022;19(7):4344. [Crossref]  [PubMed]  [PMC] 
  25. Chen GY, Wu ZF, Lin YT, Cheng KI, Huang YT, Huang ST, et al. Association between general anesthesia and root canal treatment outcomes in patients with mental disability: a retrospective cohort study. J Pers Med. 2022;12(2):213. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com