A patient with a wheezing history taking albuterol, with mucopolysaccharidoses in their medical history, needs SRP under sedation. The BEST approach is:

Correct answer: B. Hospital-based IV sedation or general anesthesia

• A. No sedation risks patient non-cooperation and does not address the complex medical needs.
• B. Correct. Mucopolysaccharidoses (MPS) — lysosomal storage diseases — cause glycosaminoglycan accumulation in tissues including the airway (macroglossia, thickened mucosa, restricted airway). Combined with active asthma (wheezing, albuterol use), this patient has significant AIRWAY RISK. Hospital-based IV sedation or GA with anesthesiology present is the safest approach, with ability to manage airway emergencies.
• C. Nitrous oxide alone would be insufficient for SRP in a patient with severe systemic compromise and potential airway issues.
• D. Outpatient IV sedation in a dental office is NOT appropriate for a patient with MPS and active asthma — airway management capability is essential in hospital settings.