treatment planning for dental general anaesthesia Flashcards
What are the advantages of dental general anaesthesia
- Eliminate need for behaviour management
- Completion of extensive treatment at single visit
- Can control complications
What are the disadvantages of dental general anaesthesia
- Risk to patient
- Range of work is limited
- Limited access to GA
- Cost
- Can be a traumatic patient
How common is the risk of general anaesthetic
1 in 300,000-500,000
How common is the risk of sedation
1 in 2-3 million
How common is the risk of LA
1 in 7 million
What risks are associated with dental GA
- Mortality (rare)
- Pain
- Nausea and vomiting
- Sore throat
- Headache
- Airway
- Cardiac
What waiting lists do we have for patients undergoing dental GA
2 lists:
- Exodonita only
- Full mouth rehabilitation
How long is the wait list for exodontia only dental GA
8-12 weeks
How long is the waiting list for full mouth rehabilitation dental ga
9 months
How much does dental GA cost for full mouth rehabilitation
£695
How much does dental GA cost for exodontia only
£500
How much does a dental outpatient visit cost
£30
What do we need to consider when recommending patients for dental GA
- Co operation
- Medical hostly
- Type and extent of treatment
How do we classify patients co operations
- Special needs
- Pre co operative
- Uncooperative
- Phobic
What do we mean by pre operative
Patients under the age of 3 who have not reached the age of maturity
What are the principles of treatment planning under GA
- Any restoration placed on a primary tooth must last the natural life time of the tooth
- Create an environment which reduces the potential for further treatment to be minimum
What restorations can we provide in primary dentition
- Occlusal/ PRRs
- Class II restorations
- Stainless steel crowns
- Pulpotomy
- Pulpectomy
- Strip crowns
Which restorations may we provide under GA
- Occlusal/ PRRs
- Stainless steel crowns
- Pulpotomy
Why don’t we carry out class II restorations under GA
Significant failure rates (Usually fail after 3 years in primary teeth)
Which primary teeth do we try not to extract
Es
Cs
Why do we try and keep the Es
As without them there can be significant medial drift of the 6s with reduction in dental arch perimeter
Why do we try not to extract the Cs
As if we remove one we have to remove the one on the other side and this can lead to significant centre line shift
How do we decide between exodontia only GA and restoration GA
- Age of child
- Parents
- Caries risk and compliance with prevention
- Extent of disease
- Special needs
What do we need to tell parents before referring their child for dental GA
- Why you feel GA is necessary
- What the alternatives are
- What the relative risks are
- Give an idea of treatment and imitation
- Warn about possible waiting times
- Emergency treatment
