Office-Based Dental Rehabilitation in Children With Special Healthcare Needs Using a Pediatric Sedation Service Model

Kirk Lalwani, Jonathan Kitchin, Peter Lax

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: 1) To review our experience with office-based sedation/anesthesia for children with special healthcare needs who underwent dental rehabilitation at our institution. 2) To compare the cost to comparable patients who underwent similar procedures in the operating room. Patients and Methods: Retrospective review of patients' medical records and the sedation service database. Group CL: 114 patients who underwent office-based dental rehabilitation (135 procedures). Group OR: 23 patients who underwent dental rehabilitation under general anesthesia in the operating room for cost comparison. Outcomes: 1) Efficacy (procedure completion rate and unplanned admissions); 2) Safety (complications and interventions); 3) Comparison of mean hospital charges billed between groups. Results: Demographics were similar in both groups. The most common specific underlying diagnoses were autism (38%), cerebral palsy/developmental delay (18%) and ADHD (4%) in both groups. Efficacy: procedure completion rate was 98.5% (2 aborted). There was 1 (0.7%) unplanned postanesthetic care unit admission due to an adverse drug event. Safety: 2 (1.5%) patients required invasive airway control. Eighteen (13.3%) patients developed transient hypoxemia. Twenty-three (17%) patients had airway obstruction needing simple intervention, and 1 (0.7%) patient had hypotension. There were no serious complications. Cost: mean total hospital charges were considerably higher in group OR ($6,126), versus group CL ($1,277), even after adjustment for inflation and length of procedure (P <.0001). Conclusion: Office-based dental rehabilitation using a pediatric sedation service model in children with special needs is efficient, and can achieve average savings of $4,849 in hospital charges per patient.

Original languageEnglish (US)
Pages (from-to)427-433
Number of pages7
JournalJournal of Oral and Maxillofacial Surgery
Volume65
Issue number3
DOIs
StatePublished - Mar 2007

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Dental Offices
Rehabilitation
Pediatrics
Delivery of Health Care
Hospital Charges
Operating Rooms
Costs and Cost Analysis
Tooth
Safety
Airway Management
Economic Inflation
Airway Obstruction
Cerebral Palsy
Autistic Disorder
Drug-Related Side Effects and Adverse Reactions
Hypotension
General Anesthesia
Medical Records
Anesthesia
Demography

ASJC Scopus subject areas

  • Dentistry(all)
  • Surgery

Cite this

Office-Based Dental Rehabilitation in Children With Special Healthcare Needs Using a Pediatric Sedation Service Model. / Lalwani, Kirk; Kitchin, Jonathan; Lax, Peter.

In: Journal of Oral and Maxillofacial Surgery, Vol. 65, No. 3, 03.2007, p. 427-433.

Research output: Contribution to journalArticle

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