A Narrative Review of Dental General Anaesthesia in Children With Special Health Care Needs

Children with special health care needs (CSHCN) cannot perform daily personal care and participate in social activities similar to healthy children, thus requiring special medical services. In the research field of oral rehabilitation, study focuses primarily on treatment under dental general anaesthesia (DGA).

This study aims to compare the perioperative treatment of CSHCN under DGA with healthy children.

A PubMed database search was performed using the MeSH and non-MeSH descriptors: 'children with special health care needs'; 'intellectual disability'; 'dental treatment'; 'endodontics'; 'restorative treatment'; 'filling treatment'; 'extraction treatment'; 'general anaesthesia' and 'sedation'. No time restrictions were applied. Literature reviews, systematic reviews, meta-analyses and clinical and preclinical trials were included.

The narrative review delineates a comprehensive framework for DGA in CSHCN. This encompasses a rigorous preoperative assessment (encompassing patient education, DGA-specific, and anaesthesia evaluation), a meticulous perioperative management protocol from medication to complication handling, and the execution of specialized intraoperative oral treatments. While DGA's primary advantage lies in enabling definitive, single-session comprehensive care, significant challenges persist, including the management of perioperative complications and ensuring effective postoperative follow-up for long-term success, all operating within the context of specific legal authorities governing dentist-administered anaesthesia.

DGA in oral management of CSHCN necessitates tailored anaesthetic planning, meticulous postop care and a systematic regulatory framework.