Dental Management Considerations in a Pediatric Patient with Moyamoya Disease

Moyamoya disease is a rare progressive cerebral arteriopathy associated with risk of ischemic and hemorrhagic brain complications. The dental care of affected individuals should be performed in a pain- and stress-free manner to decrease the chance of occurrence of episodes of hypocapnia, hypercapnia, hypotension, hypovolemia, and hypothermia. Dental treatment may be provided in an outpatient dental setting or in a hospital setting, but both venues require interdisciplinary collaboration to ensure safe delivery of patient care. In cases of general anesthesia, the perioperative management must be well-coordinated between dental clinicians and anesthesiologists to minimize the risk of adverse events. The purposes of this paper are to present the case of an eight-year-old Asian male with Moyamoya disease, and to discuss important aspects of his dental, behavioral, and medical management.