treatment planning for dental general anaesthesia

Question 1

What are the advantages of dental general anaesthesia

Answer 1

1. Eliminate need for behaviour management
2. Completion of extensive treatment at single visit
3. Can control complications

Question 2

What are the disadvantages of dental general anaesthesia

Answer 2

1. Risk to patient
2. Range of work is limited
3. Limited access to GA
4. Cost
5. Can be a traumatic patient

Question 3

How common is the risk of general anaesthetic

Answer 3

1 in 300,000-500,000

Question 4

How common is the risk of sedation

Answer 4

1 in 2-3 million

Question 5

How common is the risk of LA

Answer 5

1 in 7 million

Question 6

What risks are associated with dental GA

Answer 6

1. Mortality (rare)
2. Pain
3. Nausea and vomiting
4. Sore throat
5. Headache
6. Airway
7. Cardiac

Question 7

What waiting lists do we have for patients undergoing dental GA

Answer 7

2 lists:

1. Exodonita only
2. Full mouth rehabilitation

Question 8

How long is the wait list for exodontia only dental GA

Answer 8

8-12 weeks

Question 9

How long is the waiting list for full mouth rehabilitation dental ga

Answer 9

9 months

Question 10

How much does dental GA cost for full mouth rehabilitation

Answer 10

£695

Question 11

How much does dental GA cost for exodontia only

Answer 11

£500

Question 12

How much does a dental outpatient visit cost

Answer 12

£30

Question 13

What do we need to consider when recommending patients for dental GA

Answer 13

1. Co operation
2. Medical hostly
3. Type and extent of treatment

Question 14

How do we classify patients co operations

Answer 14

1. Special needs
2. Pre co operative
3. Uncooperative
4. Phobic

Question 15

What do we mean by pre operative

Answer 15

Patients under the age of 3 who have not reached the age of maturity

Question 16

What are the principles of treatment planning under GA

Answer 16

1. Any restoration placed on a primary tooth must last the natural life time of the tooth
2. Create an environment which reduces the potential for further treatment to be minimum

Question 17

What restorations can we provide in primary dentition

Answer 17

1. Occlusal/ PRRs
2. Class II restorations
3. Stainless steel crowns
4. Pulpotomy
5. Pulpectomy
6. Strip crowns

Question 18

Which restorations may we provide under GA

Answer 18

1. Occlusal/ PRRs
2. Stainless steel crowns
3. Pulpotomy

Question 19

Why don’t we carry out class II restorations under GA

Answer 19

Significant failure rates (Usually fail after 3 years in primary teeth)

Question 20

Which primary teeth do we try not to extract

Answer 20

Es

Cs

Question 21

Why do we try and keep the Es

Answer 21

As without them there can be significant medial drift of the 6s with reduction in dental arch perimeter

Question 22

Why do we try not to extract the Cs

Answer 22

As if we remove one we have to remove the one on the other side and this can lead to significant centre line shift

Question 23

How do we decide between exodontia only GA and restoration GA

Answer 23

1. Age of child
2. Parents
3. Caries risk and compliance with prevention
4. Extent of disease
5. Special needs

Question 24

What do we need to tell parents before referring their child for dental GA

Answer 24

1. Why you feel GA is necessary
2. What the alternatives are
3. What the relative risks are
4. Give an idea of treatment and imitation
5. Warn about possible waiting times
6. Emergency treatment