CASE REPORT: A 34-year-old man, who is 6 feet 4 inches tall and weighs 230 pounds is a dental phobic. As a young boy, he had a terrible experience with a dentist. As a result of this past episode, he has been unable to go for routine dental care and hygiene for the past nine years. The sight of a mirror, explorer, and periodontal probe made him fearful and apprehensive in the dental chair. A quick exam by his new dentist revealed subgingival calculus with the need for eight restorations that included an onlay on tooth #19. Aware of the anxiety, his dentist determined that he would need three to four hours of general anesthesia to treat him.
This man was seen for a consultation and found to be in excellent health. He had no issues with obesity, sleep apnea, diabetes, asthma, limited mouth opening, restricted airway or the use of psychiatric drugs. His ASA score was I. In summary, he was a good candidate for a general anesthetic in an out-patient setting. Medical and dental insurances deny the benefit of a general anesthetic for the use of performing routine dentistry. The patient understood this and he was willing to pay for the anesthesia cost to improve his oral/systemic health.
A four hour general anesthetic was administered and the patient was able to have the dental work completed in a safe, comfortable environment. On a follow-up call the next morning, his wife reported that he was doing well and playing golf!