Risk factors for repeated general anesthesia for dental treatment of adult patients with intellectual and/or physical disabilities

Abstract

Aim: Repeated dental treatment of patients with intellectual and/or physical disabilities under general anesthesia (GA) often becomes necessary. This study aimed to identify potential risk factors predictive of repeated dental treatment under general anesthesia. Materials and methods: Data of adult patients with intellectual and/or physical disabilities receiving dental treatment under GA within a time period of 7 years were analyzed (n = 203, mean age: 41.0 ± 14.9 years). All patients received comprehensive dental treatment (professional tooth cleaning, periodontal therapy, composite restorations, and/or extractions); patients receiving extractions only for emergency dental care were not included as a second intervention for restorative treatment often followed. Demographic, anamnestic, oral health, and treatment factors were obtained from dental records. Duration of intervals without dental treatment under GA was assessed using Kaplan-Meier statistics. Potential predictive factors were tested using univariate and multivariate cox regression analyses. Results: Thirty-five patients (17.2%) received a second and five patients (2.5%) a third dental treatment under GA during that period. In the univariate analysis, patients' age, living situation, and nutrition were associated with repeated GA. In the multivariate Cox regression analysis, only nutrition remained significant. Risk for repeated treatment increased if patients were tube-fed (HR: 7.54, p = 0.001) or received pureed/liquid food (HR: 4.32, p = 0.007) compared to nutrition without limitation. Conclusion: In adult patients with intellectual and/or physical disabilities, nutrition affects the risk for repeated dental treatment under GA. Clinical relevance: Identification of risk factors making repeated dental treatment under GA of patients with intellectual and/or physical disabilities more likely is essential to adjust preventive measures.