Anaesthesia techniques for dental patients with uncommon diseases. A series of case report

Anaesthesia techniques for dental procedures are rarely debated among dentists and anaesthesiologists. Recommendations, indications and contraindications for sedation and/or general anaesthesia in dentistry are not so clearly established. Published scientific evidence are lacking and all the recommendations are therefore based on strong agreement among professionals. Indications for dental treatment under general anaesthesia may be related to patient’s condition, to intervention or to local anaesthesia problems. Known contraindications to this treatment are the refusal by patient and/or patient’s relatives or legal representative and conditions of major risks (ASA III-IV patients). It is wide accepted, among dentists, that LA, along with iatrosedation should be routinely employed as the first treatment step. The next step should be the addition of conscious sedation, if needed, while GA should be considered as the last resort. First and second steps should be performed by the dentist also defined “sedationist”, in this setting. Benefits and risks of general anaesthesia should be considered before taking a decision, and minimal requirements are a pre-anaesthesia consultation providing information to patients and obtaining informed consent. In this paper we report our experience regarding the management of dental patients affected by uncommon systemic diseases and our opinion regarding this issue