Dentistry for profoundly disabled patients has been hampered in the Netherlands by the chronic shortage of available anaesthetic care within the few hospitals which provide it. In the Rotterdam region, two fully equipped office-based dental anaesthesia centres have been established. Profoundly handicapped patients are assessed preoperatively by four experienced and dedicated anaesthetists. The anaesthetic assistants are also always the same in order to accumulate experience. Dentists and their assistants are taught essentials of co-operation with the anaesthetist in a special course about anaesthesia for dentists. It has been shown that dental care performed in office-based-anaesthesia setting is of superior quality. Preanaesthetic assessment ensures safe fast-tracking for the day-case dentistry. Patients and their care-providers prefer office-based anaesthesia for dentistry, according to the Rotterdam approach.

        Key words: dentistry – disabled patients – anaesthetists – dental care