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Sedation of children in dental treatment

A H Arpaci, B Işik, N Cura, B Kaplan, P Bozkurt
AIM: Maternal personality traits affect child dental behaviour and have a potential link with dental treatment methods. This study aims to evaluate which maternal personality traits affect child dental behaviour. MATERIALS AND METHODS: Research was carried out upon 60 children aged between 3-12 years, who had been admitted to our clinic for tooth extraction. All children were evaluated by means of the Frankl Behavior Scale (FBS): degrees I and II represent negative behaviours, while III and IV positive behaviour...
September 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
Joe Hulin, Sarah R Baker, Zoe Marshman, Sondos Albadri, Helen D Rodd
BACKGROUND: Decision aids are tools used to help individuals faced with difficult healthcare decisions. They help patients further understand the treatment options available and encourage the sharing of information between patients and clinicians. AIM: To develop a decision aid for young patients faced with the decision to undergo dental treatment with inhalation sedation, intravenous sedation, or general anaesthesia (GA). DESIGN: Qualitative interviews with dental patients (aged 10-16 years), and their parents/guardians were used to inform the content of a draft decision aid...
September 29, 2016: International Journal of Paediatric Dentistry
Karthik Venkataraghavan, Jolly Shah, Manpreet Kaur, Krishna Trivedi, Shalin Shah, Mira Virda
INTRODUCTION: The contemporary parents are more active and participate in the decision making during dental treatment. AIM: To assess the parents' acceptance towards behavior management techniques commonly used in the pediatric dentistry in different dental situation. MATERIALS AND METHODS: Fifty-one parents participated in the study. Children's dental fear was assessed by the parents before attending power point presentation using Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS)...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Heloisa Sousa Gomes, Liliani Aires Candido Vieira, Paulo Sucasas Costa, Aline Carvalho Batista, Luciane Rezende Costa
BACKGROUND: Dental procedures may cause stress and increase the salivary cortisol levels. It is important to known if apparently simple procedures such as professional dental prophylaxis at low speed (DP) are stressful for children with dental behaviour management problems (DBMP) to help with behaviour guidance strategies. This longitudinal study aimed to evaluate if DP changes a physiological marker of stress (salivary cortisol) in children with DBMP who were referred to dental treatment under sedation...
2016: BMC Oral Health
Paul F Ashley, Susan Parekh, David R Moles, Prabhleen Anand, Laura C I MacDonald
BACKGROUND: Fear of dental pain is a major barrier to treatment for children who need dental care. The use of preoperative analgesics has the potential to reduce postoperative discomfort and intraoperative pain. We reviewed the available evidence to determine whether further research is warranted and to inform the development of prescribing guidelines. This is an update of a Cochrane review published in 2012. OBJECTIVES: To assess the effects of preoperative analgesics for intraoperative or postoperative pain relief (or both) in children and adolescents undergoing dental treatment without general anaesthesia or sedation...
2016: Cochrane Database of Systematic Reviews
Neeraj Solanki, Anuj Kumar, Neha Awasthi, Anjali Kundu, Suveet Mathur, Suresh Bidhumadhav
INTRODUCTION: Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia...
2016: Journal of Contemporary Dental Practice
M Madouh, J F Tahmassebi
AIM: To assess the treatment outcomes of using inhalation sedation for comprehensive dental care in children by utilising a modified version of the indicator of sedation need tool. METHODS: Investigating the outcomes of dental treatment of patients referred to the sedation unit at the Leeds Dental Institute when the paediatric version of the indicator of sedation need (p-IOSN) was utilised. RESULTS: Forty patients of mean age 9.99 (SD = 3...
August 2016: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
Vineet Inder Singh Khinda, Parvesh Bhuria, Paramjit Khinda, Shiminder Kallar, Gurlal Singh Brar
BACKGROUND: Diffusion hypoxia is the most serious potential complication associated with nitrous oxide. It occurs during the recovery period. Hence, administration of 100% oxygen is mandatory as suggested by many authors. AIM: The aim of this study is to evaluate the occurrence/nonoccurrence of diffusion hypoxia in two groups of patients undergoing routine dental treatment under nitrous oxide sedation when one group is subjected to 7 min of postsedation oxygenation and the second group of the patients is made to breathe room air for the similar period...
July 2016: Journal of the Indian Society of Pedodontics and Preventive Dentistry
I Abdulhamid, M Tremblay, J Stenger, V Tutag Lehr
AIM: We hypothesised that chloral hydrate is safe and effective for sedation during dental treatments for children with mild asthma. We evaluated the safety and efficacy of chloral hydrate by measuring changes in heart rate (HR), transcutaneous oxygen saturation, (SpO2), asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed throughout treatment. MATERIALS AND METHODS: Children (<10 years old) with mild asthma undergoing dental treatments received a single 65 mg/kg oral dose of chloral hydrate liquid 1 hour prior to treatment in an open label trial...
June 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
Giath Gazal, Wamiq Musheer Fareed, Muhammad Sohail Zafar, Khalid H Al-Samadani
For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, and antagonists for clinical dental treatment procedures...
July 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Parul Uppal Malhotra, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Ritu Sood, Yagyeshwar Malhotra
BACKGROUND: Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment. OBJECTIVE: Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam-ketamine in a group of children with uncooperative behavior requiring dental treatment. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study that included patients 3-9 years old with American Society of Anesthesiologists-I status...
April 2016: Contemporary Clinical Dentistry
Vasanthi Done, Ravichandrasekhar Kotha, Aron Arun Kumar Vasa, Suzan Sahana, Raghavendra Kumar Jadadoddi, Sushma Bezawada
INTRODUCTION: Most children are casual and moderately agreeable in the dental treatment environment, however some of them show practices that upset the professional and make the protected conveyance of worthy treatment extremely troublesome. For such cases dental practitioner utilizes behavior management techniques. At the point when behavioral administration procedures come up short, some type of pharmacologic sedation or anesthesia may be an important and vital option. Dental sedation is a strategy in which the utilization of a medication or drugs produce(s) a condition of depression of the central sensory system empowering treatment to be completed during which verbal contact with the patient is kept up all through the time of sedation...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Tom Friend, Paul Allen
BACKGROUND: The first line approach to managing healthy anxious children requiring dental extractions should include behavioural management and treatment under local anaesthetic. This can be coupled with conscious sedation. AIM: To evaluate alternative methods attempted prior to treatment under general anaesthesia (GA), to establish the incidence of repeat GA procedures. METHOD: Paediatric cases requiring dental extractions under GA were audited from October 2014 - December 2014 in the Oral and Maxillofacial Department, Great Western Hospital, Swindon...
January 2016: SAAD Digest
Anwen Greaves
The administration of midazolam intranasally exploits the unique structure of the nasopharynx thus ensuring rapid delivery to the systemic circulation (The Nose - Brain Pathway). The absorption of midazolam nasally is influenced by the volume and concentration of midazolam, its physicochemical properties and the characteristics of the nasal mucosa. Delivering midazolam intranasally is non-titratable. The level of conscious sedation may be equivalent to that achieved by intravenous routes but is approached in a less controlled manner...
January 2016: SAAD Digest
Aditi Kapur, Kajal Jain, A Goyal, Greg Mahoney
Sedation is frequently desired to facilitate dental procedures in uncooperative paediatric patients. Oromucosal Midazolam sedation is a popular choice among paediatric dentists world wide due to its many advantages such as ease of administration, good efficacy, presence of reversal agents and a wide margin of safety. On the other hand, many investigators have reported that midazolam sedation may not be successful for carrying out all types of dental procedures. This may be attributed to diverse nature of various treatment plans coupled with the extent of behavioural changes in the child and operator's experience...
January 2016: SAAD Digest
Jason White, Martha Wells, Kristopher L Arheart, Martin Donaldson, Marjorie A Woods
PURPOSE: The purpose of this study was to determine the opinions of parents about oral sedation in pediatric dentistry. METHODS: A 21-question questionnaire, administered to parents of children presenting for care in four pediatric dental practices, collected demographic information, media exposure to sedation, and parental knowledge/opinions regarding sedation procedures, such as NPO (nothing by mouth) guidelines, need for restraint, parental presence, and parental acceptance of treatment scenarios...
March 2016: Pediatric Dentistry
Alireza Eshghi, Mehrnaz Mohammadpour, Nasser Kaviani, Dana Tahririan, Najmeh Akhlaghi
BACKGROUND: Proper analgesic agents should be used in combination with sedative agents. Remifentanil is a synthetic narcotic/analgesic agent with a short duration effect and decreases the risk of apnea during recovery. Bispectral index system (BIS) is a new noninvasive technique for the evaluation of the depth of sedation. The aim of present clinical trial was to evaluate and compare the efficacy of intravenous sedation with propofol/midazolam/remifentanil (PMR) in comparison to propofol/midazolam/ketamine (PMK) for dental procedures in children 3-7 years of age...
January 2016: Dental Research Journal
Monica Patel, Dennis J McTigue, Sarat Thikkurissy, Henry W Fields
PURPOSE: To re-examine parental attitudes toward advanced behavior management techniques in pediatric dentistry and determine whether cost, urgency, and amount of treatment influence parental preferences. METHODS: Parents viewed previously validated videotaped clinical vignettes of four advanced behavior guidance techniques: (1) passive immobilization; (2) active immobilization; (3) general anesthesia; and (4) oral sedation. The study was conducted in a children's hospital dental clinic and a suburban private pediatric dentistry office...
January 2016: Pediatric Dentistry
N A Aminabadi, E Najafpour, S Aghaee, A Sighari Deljavan, Z Jamali, S Shirazi
PURPOSE: The use of general anaesthesia (GA) has shown significant increase in child dental patients. This study aimed to assess whether behaviour management strategies can be the effective methods for decreasing the need for GA and its over-utilisation in paediatric dentistry. METHODS: The patients (n = 240) aged 3-6 years old were selected from referrals by paediatric dentists (PD) or general dentists (GD) for dental treatment under GA. Each child's behaviour during first and subsequent appointments was assessed using the Frankl Behaviour Rating Scale...
April 2016: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
Allyson R Shepherd, Halimah Ali
Dental treatment is the commonest reason for a child to be in hospital in the UK. This is a shocking statistic for a preventable disease. How can we reduce the high numbers of dental general anaesthetics? It is essential that dental treatment under general anaesthesia (GA) is fully justifiable, ensuring that the right patients receive the right treatment. Guidance for general dental practitioners on when to refer a child for a dental GA is discussed. Treatment planning for this dentally high-risk group of children requires a holistic approach...
May 2015: Primary Dental Journal
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