Sedation or General Anaesthetic for Special Care Patients?

When faced with an anxious patient with complex needs who requires dental care, it can be difficult to decide on the most appropriate method to manage their pain and anxiety. There are a range of conscious sedation techniques that may be used, and on some occasions, general anaesthesia may be required. This paper describes the methods available and the factors influencing the decision-making process.

Sedation or general anaesthesia for treating anxious children.

Data Sources: Relevant literature was selected following searches using the following: Cochrane Central Register of Controlled Trials, Medline, Embase (OVID), System for Information on Grey Literature in Europe, Latin American and Caribbean Health Sciences Literature, ISI Web of Science; and searches were made by hand of: Journal of the American Academy of Pediatric Dentistry, Anaesthesia, British Dental Journal, British Journal of Anaesthesia, Dental Update, International Journal of Paediatric Dentistry, Journal of American Dental Association, Journal of Dentistry for Children and Pediatric Dentistry.

Study Selection: Reports were selected if they described randomised controlled clinical trials (RCT) of sedative agents compared with general anaesthesia in children and adolescents aged up to 18 years who were having dental treatment: complex surgical procedures and pseudo-randomised trials were excluded. There were no language restrictions.

Providing dental care for patients with Huntington's disease.

Unlabelled: This paper describes the genetic condition Huntington's disease and its clinical relevance to dentists. The treatment of two patients with the condition is described: one under general anaesthesia, the other with intravenous sedation.

Clinical Relevance: Dentists may have patients who develop Huntington's disease in later life, so this paper will help them consider the longer term effects of this disease and help in planning dental care.