Sedation in Paediatrics Dentistry

Year 2019, Volume: 1 Issue: 1, 28 - 36, 03.02.2019

Behiye Bolgül , Gözde Serindere

Abstract

In the Department of Paediatric Dentistry, sedation and general anaesthesia are usually required when dental treatments could not be performed in the paediatric patients because of fear and anxiety. Before treatment, the sedation provides a comfortable environment for both dentist and patient. The pharmacological agents for sedation are performed in different ways. These are inhalation, oral, rectal, sublingual, transmucosal, intranasal, intramuscular and intravenous. The oral way for sedation is preferred for simplicity, being safe and economic. The aim of this article is to give information about sedative agents and techniques.

Keywords

Sedation, paediatric dentistry, dental treatment

Pedodontide Sedasyon

Abstract

Çocuk Dişhekimliğinde çocukların korku ve kaygılarından
dolayı dental tedaviler yapılamadığında sedasyon veya genel anestezi
uygulamaları gereksinimi doğmaktadır. Bu tür çocuklarda tedavi öncesi sedasyon
yapılması hem çocuk hasta için hem de hekim için daha rahat bir ortam
oluşturur. Sedasyon için seçilen farmakolojik ajanlar bazı farklı yollarla
uygulanırlar. Bunlar inhalasyon, oral, rektal, sublingual, transmukozal,
intranazal, intramusküler ve intravenöz gibi yollardır. Sedasyon uygulanacak
çocuklarda oral yol kolay uygulanabilmesi, güvenli ve ekonomik olması gibi
özelliklerinden dolayı tercih edilmektedir. Bu makalede diş hekimliğinde
kullanılan sedatif ajanlar ve sedasyon yöntemleri hakkında bilgi verilmesi
amaçlanmaktadır.

Keywords

Sedasyon, çocuk dişhekimliği, dental girişimler

References

• 1. Leelataweedwud P, Vann JR. Adverse events and outcomes of conscious sedation for pediatric patients. J Am Dent Assoc 2001; 132: 1531-1539.
• 2. Wilson S, AnnMarie M, Paul SC, Peter L. The effects of nitrous oxide on pediatric dental patients sedated with chloral hydrate and hydroxyzine. Pediatr Dent 1998; 4: 253-258.
• 3. Firesteın SK. Patient anxiety and dental practice. J Am Dent Assoc. 1976, 93: 1180-1187.
• 4. Skaret E, Soevdsnes EK. Behavioural science in dentistry. The role of the dental hygienist in prevention and treatment of the fearful dental patient. Int J Dent Hygiene. 2005; 3: 2-6.
• 5. Corkey B, Freeman R. Predictors of dental anxiety in six year old children: Findings from a pilot study. J Dent Child. 1994; 61: 267-271.
• 6. Chadwick BL, Hosey MT. Child Taming How to Manage Children in Dental Practice. 1st ed. London: Quintessence Publishing Co. Ltd.2003.
• 7. Vitale MC, Casaschı, P, Follo R. The use of a new projective psychological test to evaluate the approach of the dentist towards young patients. Italian Journal of Paediatric Dentistry.1999; 4: 181-188.
• 8. Watson AT, Vısram A. Children’s preoperative anxiety and postoperative behaviour. Paediatr Anaesth. 2003; 13: 188-204.
• 9. Eichenbaum IW, Dunn NA. Projective drawings by children under repeated dental stress. ASDC J Dent Child. 1971; 38: 164-173.
• 10. Venham LL, Bengston D, Cipes M. Parent’s presence and the child’s response to dental stress. ASDC J Dent Child.1978; 45: 213-217.
• 11. Del Gaudio DJ, Nevid JS.Training dentally anxious children to cope. ASDC J Dent Child.1991; 58: 31-37.
• 12. Klingberg G, Hwang CP. Children’s dental fear picture test (CDFP): A projective test for the assessment of child dental fear. ASCD J Dent Child.1994; 61: 89-96.
• 13. Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory? ASDC J Dent Child. 1962; 2: 150-163.
• 14. Kain ZN, Mayes LC, Cicchetti DV, Bagnall AL, Finley JD, Hofstadter MB. (1997). The Yale Preoperative Anxiety Scale: How does it compare with a “gold standard”?. Anesth Analg.1997; 85: 783-788.
• 15. Nathan JE. Managing behaviour of precooperative children. Dent Clin Nort Am.1995; 39: 789-816.
• 16. Braham RL, Bogetz MS, Kimura M. Pharmacologic patient management in pediatric dentistry: An update. ASDC J Dent Child. 1993; 60: 270-280.
• 17. Hosey MT. UK national clinical guidelines in paediatric dentistry. Managing anxious children: The use of conscious sedation in paediatric dentistry. Int J Paediatr Dent.2002; 12: 359-372.
• 18. Wilson S. Pharmacologic management of the pediatric dental patient. Pediatr Dent.2004; 26: 131-136.
• 19. American academy of pediatrıc dentistry. Clinical guideline on the elective use of consious sedation, deep sedation, and general anesthesia in pediatric dental patients. Pediatr Dent.2003; 25: 73-78.
• 20. Haas DA. Oral and inhalation concious sedation. Dent Cli North Am.1999; 43(3): 341-359.
• 21. American Academy of Pediatric Dentistry. Guideline on behaviour guidance for the pediatric dental patient. Pediatr Dent 2005-2006; 27: 92-100.
• 22. Malamed SF. Sedation: A Guide to Patient Management. 4th ed. St. Louis: Mosby, An Affiliate Elsevier Science,2003.
• 23. Mcdonald RE, Avery DR. Dentistry for the child and adolescent. 7th ed. St. Louis: Mosby,2000.
• 24. Vallerand WP, Vallerand AH, Hall MB. Evaluation of the sedative combination of nitrous oxide and orally administered diazepam. Oral Surg Oral Med Oral Pathol. 1991 Jun;71(6):660-4.
• 25. Bennett CR. Local anesthesia and pain control in dental practica. 5th ed CV, Mosby. St Louis,1974: 232-47.
• 26. Hartgraves PM, Primosch RE. An evaluation of oral and nasal midazolam for pediatric dental sedation. ASDC J Dent Child. 1994 May-Jun;61(3):175-81.
• 27. Walter SH, Simth G. Anesthesia. Anesthesia for dental surgery. Chapter 35, Vol:1, Frome and London Butter and Tanne Ltd. 1989:660-4.
• 28. Laird WR. The yankee dodge: some new observations on the discovery of anaesthesia. Br Dent J.1990; 169: 217-219.
• 29. Wilson S. A survey of the American Academy of Pediatric Dentistry membership: nitrous oxide and sedation. Pediatr Dent. 1996; 18: 287-293.
• 30. Haney KL, McWhorter AG, Seale NS. An assessment of the success of meperidine and promethazine sedation in medically compromised children. ASDC J Dent Child. 1993 Jul-Oct;60(4-5):288-94.
• 31. Nahata MC, Clotz MA, Krogg EA. Adverse effects of meperidine, promethazine, and chlorpromazine for sedation in pediatric patients. Clin Pediatr (Phila). 1985 Oct;24(10):558-60.
• 32. Gan TJ. Pharmacokinetic and pharmacodynamic characteristics of medications used for moderate sedation. Clin Pharmacokinet 2006; 45: 855–869.
• 33. Önçağ Ö. Pedodontide Sedasyon. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi, 1999; 26: 201-210.
• 34. Süzer Ö. Farmakolojinin Temelleri. 1st ed. İstanbul: Nobel Tıp Kitapevleri, 2002.
• 35. Krafft TC , Krämer N , Kunzelmann KH , Hickel R. Experience with midazolam as sedative in the dental treatment of uncooperative children. ASDC Journal of Dentistry for Children 1993; 60(4-5):295-9.
• 36. Nunn IF, Utting IE, Brown BR. General. Anesthesia; general anesthesia and analgeaia in the dental chair. Analgesia and Sedation. Butterworth and Co Ltd. Anchor Press Ltd Bodmin, Cornwall, 1988; 1015-7.
• 37. Badalaty MM, Houpt MI, Koenigsberg SR, Maxwell KC, DesJardins PJ. A comparison of chloral hydrate and diazepam sedation in young children. Pediatr Dent 1990; 12(1): 33-7.
• 38. Burtles R, Astley B. Lorazepam in Children: A double-blind trial comparing lorazespam, diazepam, trimeprazine and placebo. BJA: British Journal of Anaesthesia 1983; 55(4): 275-9.
• 39. Dominic PL. The use of hypnosis for smooth sedation induction and reduction of postoperative violent emergencies from anesthesia in pediatric dental patients. Journal of Dentsitry for Children 1994; 132-5.
• 40. Houpt MI, Sheskin RB, Koenigsberg SR, Desjardins PJ, Shey Z. Assessing chloral hydrate dosage for young children. ASDC J Dent Child. 1985 Sep-Oct;52(5):364-9.
• 41. Dural EAÖ. Farmakoloji. 3.Baskı. İstanbul: Nobel Kitapevleri,2002.
• 42. Ram D, Mamber E, Chosack A, Fuks AB. The effect of metoclopramide and hydroxyzine in sedation of infants undergoing dental treatment. ASDC J Dent Child. 1999 Jan-Feb;66(1):49-52, 13.