General anesthesia as one visit dental management for down syndrome child with hypothyroidism and post closure of heart valves

Abstract

Introduction: Several studies have stated that the prevalence of dental caries in children with Down Syndrome (DS) is quite high (89%), as is the prevalence of periodontitis (59%). Several systemic conditions with DS always hamper their dental management. Thus, appropriate management behavior is needed to improve oral health care. Case History: An 8-year-old boy, with DS, complaining that his teeth often experienced spontaneous pain and swelling. Medical history revealed that the patient had hypothyroidism and post-closure of heart valves. During intraoral examination, multiple caries and multiple gangrene radix were found. The patient was uncooperative (Frankl scale number 1). One-visit dental management by GA was performed on the patient, resulting in the patient never experiencing toothache again and having a good appetite. Discussion: Uncooperative DS children with several accompanying systemic conditions make dental examination and treatment difficult to do in regular dental office. Because of these conditions require appropriate behavioral management to carry out dental treatment. Based on aspects of safety and effectiveness, GA is one of the behavioral management that can be done. Related to it, GA requires a multidisciplinary team, to consider each stage of the procedure. This method makes the dental treatment can be done in one-visit, helps decrease the child’s anxiety, and makes the dental experience safe and less painful. Conclusion: For patients with several systemic conditions, behavioral management with GA as one-visit dental management is a good option.