anesthesia use C D A J O U R N A L , V O L 5 0 , Nº 6
C.E. Credit
Strategies To Reduce the Use of General Anesthesia for Children and Adolescents With Special Health Care Needs: Dental Desensitization and ‘Shorten the Line’ Models Jean Calvo, DDS, MPH; Paul Glassman DDS, MA, MBA; Tara Glavin, MA, BCBA; and Helen Mo, DMD, MS
abstract Background: Providing access to preventive and restorative dental care for children and adolescents with special health care needs (SHCN) is an imperative step in improving and maintaining their overall health. Often children and adolescents with SHCN receive referrals for dental treatment with sedation or general anesthesia. However, many children who are currently referred for dental treatment using general anesthesia could have dental care using less invasive, costly and risky methods with a series of strategies in the community and dental setting. Methods: The aim of this paper is to describe two models of reducing indications and referral for dental care with sedation and/or general anesthesia: a community-based comprehensive care system referred to as “shorten the line” and the use of desensitization in the dental setting. Results: The “shorten the line” strategy is a system involving dental hygienists, dental assistants, care coordinators and behavior support specialists deployed in community locations such as preschools, schools, residential facilities and day programs. The dental desensitization model described in this paper integrates the use of telehealth, previsit imagery, interprofessional care, systematic desensitization, dental office accommodations and home oral health practice. Conclusion: By implementing innovative models of care for patients with SHCN, it is possible to increase the completion of dental treatment for patients with SHCN in a community location or dental office rather than referring the patient for care with general anesthesia.
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