Risks of general anesthesia for the special needs dental patient.

The risk of dental rehabilitation under general anesthesia has multiple contributing factors. The literature has addressed the general anesthetic risk of dental general anesthesia and sedation in the operating room and the office settings, but more studies are needed to address the special needs population in particular. There is still a great need for more studies to assess the risk versus benefit for special need population as well as to stratify such risk in order to assist care providers in decision making as well as in sharing such risk concerns with patients, caretakers, and guardians. One recommended approach is to conduct a national retrospective study of patients treated under general anesthesia in the past 10 years in all the various settings and assess the associated risks and complications related to their physical status and the underlying physical and mental disabilities. The product of such a study could be a stratification of risk versus benefit as well as some guidelines for decision making as far as which kind of procedures should be conducted under general anesthesia while weighing the level of risk for the particular patient. Although access to care is not a direct risk factor, it can certainly deter timely treatment and intervention for patients with special needs.