Sanace chrupu neošetřitelných pacientův celkové anestezii

Dental Treatment of Untreatable Patients under GeneralAnaesthesia

Summary:
The paper analyzes a group of 32 adult non-cooperating patients who in1997–1999 had dental treatment under general anaesthesia. In the majority mental patientswere involved, people with mental affections and two subjects with an uncontrollable vomitingreflex. The majority were in domiciliary care. The patients were examined and had a singletreatment under general anaesthesia with orotracheal intubation. The authors assessed theavailability of this special care for untreatable patients, the dental cariosity using the DMFindex, the mean period of treatment, the number of operations, materials used, and types ofcaries according to Black’s classification. The distance covered on account of treatment in 13subjects (40.6 %) was more than 60 km. Collaboration with parents and general practitionersdid not have the desirable standard. The mean DMF value was 16.84 which confirms a highcariosity. The patients were treated on average for one hour and 35 minutes. During this period5.97 operations were made incl. 2.13 extractions and 3.84 fillings. From the total number of123 fillings the majority belonged into the Black class V – 38 (30.85 %) and into class I – 32(26.02 %), followed by 29 (23.58 %) class III, 13 (10.57 %) class IV and fewest 11 (8.94 %) inclass II. A large proportion of cavities on the dental neck was due to poor hygiene and poordietary habits. The most frequently used material was amalgam in 61 cases (49.59 %),compomer in 40 cases (35.52 %) and glass ionomeric cement in 22 patients (17.89 %). Inuntreatable patients dental treatment under general anaesthesia is frequently the onlysolution. Greater availability of this special care and motivation of guardians cold ensureregular dental treatment of problem subjects and would help to preserve their dental functionto more advanced age.

Key words:
dental treatment – untreatable patient – general anaesthesia