scholarly journals Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Galeotti ◽  
Annelyse Garret Bernardin ◽  
Vincenzo D’Antò ◽  
Gianmaria Fabrizio Ferrazzano ◽  
Tina Gentile ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Adverse Effects ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Young Patients ◽  
Dental Patients ◽  
Dental Procedures ◽  
Significant Difference ◽  
Disabled Patients

Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients.Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score.Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment.Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

Effects of Video Information on Parental Preoperative Anxiety Level and Their Perception of Conscious Sedation vs. General Anesthesia for the Dental Treatment of Their Young Child

2007 ◽  
Vol 31 (2) ◽  
pp. 90-92 ◽  
Author(s):  
Ari Kupietzky
Keyword(s):  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Treatment Options ◽  
Young Patients ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Video Information ◽  
Significant Difference ◽  
The Impact

Aim. To investigate the impact of video information on parental preoperative anxiety and perception and their preference of conscious sedation versus general anesthesia for the dental treatment of young patients. Method/materials. Parents were given a verbal explanation regarding the two treatment options and were then asked to fill out a prescreening questionnaire. Their preference for mode of treatment was obtained and their preoperative anxiety level was measured on a visual analog scale (VAS). A video film depicting two children under going dental treatment with conscious sedation (CS) and a third child undergoing general anesthesia (GA) for dental treatment was shown to the parent. Following the viewing of the video film a post-screening questionnaire was given. Parents' post screening anxiety was measured and they were asked if their perception and preference of the two modes of treatment remained the same or changed. Results. 40 parents were included and completed the trial. The prescreening anxiety level of parents was 2.79 (± 1.05, SD) and was not significantly different than the post screening anxiety level of 2.91 (± .99 SD, paired t- test p=0.432). The majority of parents preferred CS to GA for the treatment of their child prior to screening of the video. Among the few who chose GA (n=5) all but one changed their choice after viewing the video to CS. However, this difference was not found to be statistically significant due to the small number of subjects in this group (McNemar test, p = 0.125). Most parents voiced the opinion that the video film contributed to their knowledge and also considered GA as having more risks than CS. An interesting finding was that a statistically significant difference was found regarding parent's perception of the two procedures and what they actually saw in the video. The majority of parents stated that their initial perception of GA was not similar to their viewing experience, conversely, CS matched their expectations. Conclusion. Parents' anxiety regarding their child's dental treatment under GA or CS is not affected by the viewing of a video film depicting either method. Parent's perception of GA is different than the actual procedure and may affect their choice of treatment.

A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period

2018 ◽  
Vol 42 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Sreekanth Kumar Mallineni ◽  
Cynthia Kar Y Yiu
Keyword(s):  
Stainless Steel ◽  
General Anesthesia ◽  
Special Needs ◽  
Recovery Time ◽  
Dental Treatment ◽  
Composite Restorations ◽  
Dental Procedures ◽  
Significant Difference ◽  
Operative Recovery ◽  
Amalgam Restorations

Objective: The purpose of this study was to perform a comprehensive audit of dental treatment provided to special needs patients (SNP) under general anesthesia (GA) over a ten-year period. Study design: Special needs patients who received dental treatment under GA as an in-patient at Queen Mary Hospital, Hong Kong SAR during the time period January 2002 and December 2011 were included in the study. The study population was divided into three groups, based on age (<6years, 6–12 years, >12 years). One-way ANOVA was used to evaluate the effect of “age group” on duration of treatment, post-recovery time, treatment procedures and utilization of different restorative materials. Kappa statistics were used for intra-examiner reliability. Results: A total of 275 patients (174 males and 101 females) were included in the study. The mean age of the patients at the time they received GA was 12.37±10.18 years. Dental procedures performed were mostly restorative in nature (47%). The >12 years group had significantly shorter treatment duration (p<0.05). No significant difference in post-operative recovery time was observed among the three age groups (p>0.05). The <6 years group received significantly less preventive, but more restorative procedures (p<0.05). Significantly fewer extractions were performed in the 6–12 years group (p<0.05). The use of composite restorations was significantly higher in the <6 years group; while amalgam restorations were more frequently used in the >12 years group (P<0.05). Stainless steel crowns were more frequently employed in SNP under 12 years of age (p<0.05). Intra-examiner reliability was good (k=0.94). Conclusions: Most of the dental procedures performed under GA on SNP were restorative procedures. For children less than 6 years of age, had longer treatment time under GA. Composite restorations and stainless steel crowns were more frequently used in the primary dentition and amalgam restorations were more frequently employed in the permanent dentition.

Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Dental Procedures ◽  
Dental Staff ◽  
Significant Difference ◽  
Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

scholarly journals Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial

2017 ◽  
Vol 10 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Fernando M Baeder ◽  
Daniel F Silva ◽  
Ana CL de Albuquerque ◽  
Maria TBR Santos
Keyword(s):  
Clinical Trial ◽  
Nitrous Oxide ◽  
Cerebral Palsy ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Test Analysis ◽  
Significance Level ◽  
Dental Procedures ◽  
Chi Squared ◽  
Student’S T

ABSTRACT Introduction Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment. Aim This study aimed to evaluate the use of conscious sedation with nitrous oxide (N2O) to control stress during dental treatment in individuals with CP using as parameters: Venham score (VS), heart rate (HR), and respiratory rate (RR). Materials and methods A total of 77 CP patients >3 years of age with a mean age of 11.8 (± 6.4) years were evaluated in a rehabilitation center. Stress control was measured at the following time points: T1 (presedation), T2 (induction), T3 (sedated patient), and T4 (end). Student's t-test, the Chi-squared test, analysis of variance (ANOVA), and the McNemar test were used. The significance level was 5%. Results Sedation ranged between 10 and 60% N2O, with an average of 35.6% (± 10.4). The RR did not vary among the times (p = 0.12). The HR and VS varied significantly between times (p < 0.001), as significantly higher values of HR were observed at T1. Conclusion Conscious sedation with N2O during dental care controls stress in CP patients, as verified by a decrease in HR, and does not promote respiratory depression. Higher concentrations of N2O are recommended for CP patients with tachycardia. Clinical significance Sedation modifies behavior during dental procedures, facilitating patient collaboration. How to cite this article Baeder FM, Silva DF, de Albuquerque ACL, Santos MTBR. Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial. Int J Clin Pediatr Dent 2017;10(4):384-390.

scholarly journals Risk of respiratory depression at use of nitrous oxide on individuals with cerebral palsy: a clinical trial

2021 ◽  
Vol 10 (13) ◽  
pp. e198101320774
Author(s):  
Fernando Martins Baeder ◽  
Daniel Furtado Silva ◽  
Ana Carolina Lyra de Albuquerque ◽  
Dênis Clay Lopes dos Santos ◽  
Andrea Pavanello ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Cerebral Palsy ◽  
Respiratory Depression ◽  
Dental Care ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Outpatient Setting ◽  
Significance Level ◽  
Significant Difference ◽  
N2o Titration

The dental care for individuals with cerebral palsy (CP) often result in the referral of patients for general anesthesia. Conscious sedation with nitrous oxide (N2O) could be an alternative resource, from a behavioral and physiological point of view, and could favor dental care in an outpatient setting. This study aimed to evaluate the influence of conscious sedation with N2O on respiratory rate (RR) and oxygen saturation (SpO2) in the dental treatment of individuals with CP. Seventy-seven patients with CP, over 3 years old, regardless of gender and ethnicity, were evaluated with the measurement of N2O titration, RR and SpO2 in four moments: initial, 5 minutes after sedation, 10 minutes after anesthesia and 5 minutes after removal of the N2O. Student's t test and ANOVA F were used, with a significance level of 5%. The variation in N2O titration did not generate significant variation in RR (p = 0.122). There was a significant difference in SpO2 between T1 and other times. It can be said that conscious sedation is not influenced by N2O titration, does not cause respiratory depression or any clinically significant change in SpO2, confirming the safety of use in an outpatient setting.

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

Utility of Bispectral Index Monitoring during Deep Sedation in Pediatric Dental Patients

2014 ◽  
Vol 39 (1) ◽  
pp. 291-296 ◽  
Author(s):  
C Dag ◽  
T Bezgin ◽  
N Özalp ◽  
G Gölcüklü Aydın
Keyword(s):  
Dental Treatment ◽  
Deep Sedation ◽  
Pediatric Dentistry ◽  
P Value ◽  
Chi Square ◽  
Mean Values ◽  
Dental Patients ◽  
Physiological Variables ◽  
Paired Samples ◽  
Significant Difference

Objective: The aim of this study was to compare the total medicament doses and recovery profiles of patients for whom Bispectral Analysis (BIS) monitor was used to monitor sedation. Study design: Thirty-four uncooperative paediatric patients aged 3-6 years who attended to the Department of Pediatric Dentistry for dental treatment were enrolled in the study. Patients were randomly divided into 2 groups of 17 patients each. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded. In one group (BIS-monitored group), drugs were administered to maintain patients’ BIS values between 60-70, while the other group (Non-BIS-monitored Group) was not monitored using BIS. Data was evaluated by Chi-square, Mann Whitney U, Independent Samples t, Paired Samples t and Wilcoxon signed tests, with a p-value of &lt;0.05 considered to be statistically significant. Results: There was no significant difference in total anesthetic doses, incidence of adverse events or recovery profiles of patients between non- BIS-monitored and BIS-monitored groups (p≯0.05). However, distinct correlation was determined among mean values of UMSS and BIS values (p&lt;0.05). Conclusion: BIS represents no advantage over the current commonly accepted methods for monitoring sedation depth in children.

scholarly journals A New Concept for the Treatment and Rehabilitation of Patients with Pathologic Comorbidities Using Cutting-Edge Digital Technologies in Dental Orthopaedics

2020 ◽  
Vol 14 (04) ◽  
pp. 533-538
Author(s):  
Alexey V. Yumashev ◽  
Maria V. Mikhailova ◽  
Igor V. Fomin ◽  
Jiaqi Li ◽  
Bowen Yang
Keyword(s):  
Statistical Analysis ◽  
Dental Treatment ◽  
Management Strategies ◽  
Digital Technologies ◽  
Statistical Probability ◽  
Dental Patients ◽  
Dental Examination ◽  
Dental Procedures ◽  
Probability Criterion

Abstract Objectives This article investigates the specific aspects of overactive or exaggerated vomiting reflexes affecting the procedure of dental examination and impression in patients with complete secondary adentia, who need orthopaedic dental treatment. Materials and Methods The prevailing manifestation degree of exaggerated vomiting reflex was diagnosed among patients with complete secondary adentia and exaggerated vomiting reflex. Statistical Analysis Exaggerated vomiting reflexes occur when a patient suffers from dentophobia, the term, which is otherwise known as the fear of dentists. The study was performed using methods of mathematical statistics, including the Pearson χ2 criterion and the statistical probability criterion (p). Results The role of an exaggerated vomiting reflex was revealed in the development of patients’ dentophobic experiences, and the nature of such experiences was established. Variations in dentophobic reactions were distinguished and management strategies were studied for patients with complete secondary adentia and exaggerated vomiting reflex. Conclusions These studies were aimed at preventing the development of vomiting reflex during dental procedures and at identifying an optimal strategy for stopping exaggerated vomiting reflex. The role of the vomiting reflex in the orthopaedic treatment of dental patients was determined.

Attitudes to Conscious Sedation in Patients Attending an Emergency Dental Clinic

2005 ◽  
Vol os12 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Edith M Allen ◽  
Nick M Girdler
Keyword(s):  
Conscious Sedation ◽  
Dental Treatment ◽  
Dental Health ◽  
Dental Anxiety ◽  
Dental Clinic ◽  
Dental Patients ◽  
The Past ◽  
Anxious Group ◽  
Dental Appointment ◽  
The Impact

Introduction Anxiety and fear in relation to dentistry are long-standing problems and the incidence of dental fear does not appear to be decreasing. It can result in poor dental health and wastage of clinical time. Conscious sedation is one method of allaying anxiety in dental patients and enables such patients to accept dental treatment. Aims, Materials and Methods A questionnaire survey was undertaken among patients attending an emergency dental clinic. Its aims were to assess the levels of dental anxiety in these subjects, the impact on their attendance for dental treatment, and their knowledge of and desire to have conscious sedation, should it be available. Results The results indicated that in the 72 patients who responded, levels of anxiety regarding dental treatment were high, with 49 (68%) claiming some nervousness or worse. Thirty-one (43%) cited fear/nervousness as a reason for delaying making a dental appointment. Twenty-seven (38%) were not aware of the existence of conscious sedation for dental treatment, of whom half reported that they were in the highly anxious group. Forty (56%) respondents said they would like to have sedation if it were available. Twenty-five (35%) claimed to have received sedation for dental treatment in the past. Conclusion It was concluded that the availability of dental sedation was currently not matching the needs and demands of several patients who took part in the survey. Increased availability of dental sedation could remove a barrier to dental care for many highly anxious dental patients.

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