Dental treatment under intravenous sedation prolongs longevity of a fixed prosthesis in patients with intellectual disabilities

“…Such broad applicability supports the concept of inclusivity promoted by the Australian Government (Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, 2023) and the World Health Organization (2024), such that adults with IDDs should have equal access to services such as preventative healthcare procedures. Earlier research in this sector has been focused on outcomes of a single procedure or sedation intervention only (Vaessen et al, 2017; Yamaguchi‐Komeyama et al, 2022), or been conducted in single cases only (Grider et al, 2012; Meindl et al, 2019). Whilst versatility is required for operational effectiveness and fiscal management, such an inclusive model pragmatically targets the needs of the broader IDD community versus individuals within it.…”

“…Not surprising was the observation that more than half of the secondary procedures were oral health reviews, as multiple challenges to achieving normal dental outcomes exist for adults with IDDs which were amplified by COVID‐19. Pre‐pandemic issues such as low comprehension of oral hygiene and independence in teeth cleaning, and elevated levels of fear associated with dental procedures (Yamaguchi‐Komeyama et al, 2022), are linked to poor dental outcomes (Vaessen et al, 2017; Yamaguchi‐Komeyama et al, 2022). These include untreated carious lesions, poorer oral hygiene, and a higher number of missing to filled teeth than the general population (Vaessen et al, 2017).…”

“…Furthermore, a range of nonpharmacological intervention models targeting individuals with IDDs now exist, using methods such as the TEACHH® program (Orellana et al, 2014), graduated exposure (Kupzyk & Allen, 2019), auditory or visual stimuli distraction (Fakhruddin & El Batawi, 2017), individualized adaptive care plans (Winterberg et al, 2022), behavioral intervention programs (Berens et al, 2022) and virtual reality (Meindl et al, 2019). There is also substantial literature focused on models that exclusively feature pharmacological interventions such as nitrous oxide, midazolam, or general anesthetic (Brathen et al, 2022; Choi & Doh, 2021; Garret‐Bernardin et al, 2023; Yamaguchi‐Komeyama et al, 2022). However, as many of these models were examined within a pediatric cohort (Brathen et al, 2022; Garret‐Bernardin et al, 2023; Winterberg et al, 2022), or within adults who presented with either a single, specific disability type, procedure type, or sedation type (Garret‐Bernardin et al, 2023; Orellana et al, 2014; Vaessen et al, 2017; Yamaguchi‐Komeyama et al, 2022), their application to a health service which provides healthcare to a typically heterogeneous adult disability cohort is uncertain.…”