title: Special Care Dentistry Association consensus statement on sedation, anesthesia, and alternative techniques for people with special needs.
abstract: Many people with special needs (PSN) have difficulty having good oral health or accessing oral health services because of a disability or medical condition. The number of people with these conditions living in community settings and needing oral health services is increasing dramatically due to advances in medical care, deinstitutionalization, and changing societal values. Many of these individuals require additional supports beyond local anesthesia in order to receive dental treatment services. The purpose of this consensus statement is to focus on the decision-making process for choosing a method of treatment or a combination of methods for facilitating dental treatment for these individuals. These guidelines are intended to assist oral health professionals and other interested parties in planning and carrying out oral health treatment for PSN. Considerations for planning treatment and considerations for each of several alternative modalities are listed. Also discussed are considerations for the use of combinations of modalities and considerations for the repeated or frequent use of these modalities. Finally, the need to advocate for adequate education and reimbursement for the full range of support alternatives is addressed. The Special Care Dentistry Association (SCDA) is dedicated to improving oral health and well being of PSN. The SCDA hopes that these guidelines can help oral health professionals and other interested individuals and groups to work together to ensure that PSN can achieve a "lifetime of oral health."
authors.affiliation: University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA. pglassman@pacific.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Glassman
authors.forename: Anthony
authors.initials: A
authors.lastname: Caputo
authors.forename: Nancy
authors.initials: N
authors.lastname: Dougherty
authors.forename: Ray
authors.initials: R
authors.lastname: Lyons
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Messieha
authors.forename: Christine
authors.initials: C
authors.lastname: Miller
authors.forename: Bruce
authors.initials: B
authors.lastname: Peltier
authors.forename: Maureen
authors.initials: M
authors.lastname: Romer
mesh_terms: D000223:Adaptation, Psychological; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D032763:Behavior Control; D016292:Procedural Sedation; D032921:Consensus; D003657:Decision Making; D054810:Deep Sedation; D016854:Dental Anxiety / Q000517:prevention & control; D017742:Dental Care for Chronically Ill / Q000191:economics; D003730:Dental Care for Persons with Disabilities / Q000191:economics; D003756:Dental Hygienists / Q000193:education; D003812:Dentist-Patient Relations; D004497:Education, Dental; D006801:Humans; D011313:Preventive Dentistry; D012051:Reimbursement Mechanisms; D012944:Social Support