Medications Usage in Intellectually/Developmentally Disabled Adults Treated Under General Anesthesia

Objectives: This study investigated medication usage by intellectually/developmentally disabled (I/DD) adults receiving dental treatment utilizing general anesthesia (GA).  Associations between medication usage and untreated caries were explored. 

 

Methods: This cross-sectional study utilized data from clinical information recorded at the time of treatment at the Tufts Dental Facilities (TDF) in the axiUm electronic health record (EHR).  The study group consisted of 241 developmentally disabled adults ≥ 20 years of age who received dental treatment under general anesthesia between April 1^st, 2009 - March 31^st, 2010. Medication usage for each patient was collected from axiUm and recorded in an electronic spreadsheet program (MS Excel). The compiled database was converted to SAS data sets for analysis (Version 9.2).

 

Results:    The mean (SD) age of this population was 45.27 (11.22) years.  There were 145 males (60.17%) and 96 females (39.83%).  The mean (SD) number of medications each patient was on was 6.86 (3.96) and ranged from 0 to 19.  NSAIDs were the most common, with 58.51% of the patients taking at least one, followed by anticonvulsants (53.11%), then anxiolytics (39.83%), then antidepressants (38.59%), followed by antipsychotics (34.44%) and lastly, antihypertensive medications (21.99%).  The untreated caries rate in the study population was 61.83% (149/241).  Those on 7 or more medications had an untreated caries rate of 60.5% compared to 63.1% for those individuals taking fewer than 7 medications.

Conclusions:   The percentage of the study population taking 7 or more medications was significantly higher than reported for U.S. population (>60% vs. 25%).  Nearly 40% of the population was prescribed medications known to cause zerostomia.   The prevalence of untreated caries was significantly higher for the study population than reported in national surveillance data.  Follow-up studies are indicated to examine the impact of medication usage on the oral health of adults with I/DD requiring GA for dental treatment.