Medical Management of Dental Anxiety

2018 ◽  
Vol 7 (4) ◽  
pp. 40-44
Author(s):  
Paul Coulthard
Keyword(s):  
Dental Care ◽  
Medical Management ◽  
Conscious Sedation ◽  
Oral Surgery ◽  
Dental Anxiety ◽  
Invasive Treatment ◽  
Safe Practice ◽  
Management Techniques

The use of medical management techniques for the management of anxiety is fundamental to the practice of dentistry. Around 7% of the population are likely to need these techniques for general dental care and a higher proportion for more invasive treatment such as oral surgery. This paper highlights the current expectation of effective and safe practice of conscious sedation techniques in light of recent updated guidance from several UK institutions.

The Establishment of an Intravenous Conscious Sedation Service for Adult Patients in a Primary Dental Care Setting

Dental Update ◽  
2020 ◽  
Vol 47 (1) ◽  
pp. 22-36
Author(s):  
Rebecca SL Binnie ◽  
Nigel D Robb ◽  
Sarah L Manton ◽  
Stephen J Bonsor
Keyword(s):  
Surgical Procedures ◽  
Dental Care ◽  
Clinical Relevance ◽  
Care Setting ◽  
Conscious Sedation ◽  
Dental Anxiety ◽  
Adult Patients ◽  
Behaviour Management ◽  
Dental Practitioners ◽  
Management Techniques

Dental anxiety is common within the population and can detrimentally affect the delivery of dental care for those patients affected. Non-pharmacological-based behaviour management techniques are available to the clinician but may not be sufficient or applicable for every patient. In such cases, intravenous conscious sedation with midazolam has been demonstrated to be safe, effective and well tolerated. The present article reviews the criteria and guidance which must be addressed by the dental team when establishing an intravenous conscious sedation service in a primary dental care setting. CPD/Clinical Relevance: General dental practitioners may wish to consider establishing a conscious sedation service in their practices to facilitate the care of nervous patients or those undergoing prolonged, unpleasant treatments such as surgical procedures. The present paper aims to highlight the considerations which require to be addressed in order to establish such a service for adult patients using intravenous midazolam.

Overview of conscious sedation for primary dental care

2010 ◽  
Vol 1 (3) ◽  
pp. 99-102 ◽  
Author(s):  
KE Wilson ◽  
NM Girdler
Keyword(s):  
Dental Care ◽  
Conscious Sedation ◽  
Dental Health ◽  
Dental Anxiety ◽  
Effective Control ◽  
Major Barrier ◽  
Dental Patients ◽  
Adults And Children ◽  
Dental Health Survey ◽  
The Uk

Effective control of pain and anxiety is an essential part of dental practice. Dental anxiety can act as a major barrier to the receipt of dental care, affecting both adults and children. The UK Adult Dental Health Survey reported that up to 45% of adults claimed fear was their reason for non-attendance at the dentist.1 Simple behavioural management techniques are used to effectively treat the majority of dental patients, however, where these have not been effective or are inappropriate, the use of conscious sedation may provide a safe and effective management option, with minimal physiological and psychological stress to the patient.2.

Dental care for the bariatric patient

Dental Update ◽  
2021 ◽  
Vol 48 (4) ◽  
pp. 302-306
Author(s):  
Jessica Hamilton ◽  
Mary Gittins ◽  
Andrew Geddis-Regan ◽  
Graham Walton
Keyword(s):  
General Anaesthesia ◽  
Dental Care ◽  
Clinical Relevance ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Careful Consideration ◽  
Equitable Access ◽  
Bariatric Patient ◽  
Access To Dental Care ◽  
Obese Population

As the overweight and obese population increases, one must be mindful of the implications on the delivery of dental care to this group. Appropriate facilities must be available, which may warrant structural and equipment adaptations to clinical and non-clinical areas. The complexity of dental treatment planning and delivery may be compounded by medical comorbidities, and careful consideration must be given to the suitability and safety of conscious sedation and general anaesthesia in order to facilitate treatment. This article aims to discuss how safe provision and equitable access to dental care can be achieved for the bariatric population. CPD/Clinical Relevance: This article aims to discuss the challenges posed by the increase in the overweight and obese population and considerations to be taken for provision of safe and equitable bariatric dental care.

scholarly journals CORRELATION BETWEEN ANXIETY IN MOTHERS AND CHILDREN WITH SENSORY IMPAIRMENTS BEFORE DENTAL TREATMENT

2018 ◽  
Vol 9 ◽  
pp. 144
Author(s):  
Margaretha Sovaria ◽  
Eka S Shofiyah ◽  
Mochamad F Rizal ◽  
Sarworini B Budiardjo
Keyword(s):  
Dental Care ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
The Body ◽  
Waiting Room ◽  
Sensory Impairments ◽  
Mothers And Children ◽  
Pediatric Dentists ◽  
Children's Development ◽  
Children’S Development

Objective: Mothers have very important roles in their children’s development. Their instinctive love develops strong emotional connections with their children, especially when their children have sensory impairments (SI). Feelings experienced by mothers, such as anxiety toward dental treatment, can affect their children’s emotions. Salivary alpha amylase (sAA) has been proposed as a biomarker of stress due to its sensitivity to changes in the body, such as dental anxiety. This study aimed to analyze the relationship between sAA levels in mothers and children with SI before dental treatment.Methods: Measurement of sAA from sixty pairs of children with SI and their mothers was taken together in the waiting room before the children’s dental treatment. Spearman’s analysis was used to find the correlation between their sAA levels.Results: In this study, sAA levels in mothers accompanying their children with SI correlated significantly with their children’s sAA levels (r=0.533; p<0.002).Conclusions: The correlation between dental anxiety in mothers and children with SI before dental treatment was found to be significant.Practical Implications: Anxiety toward dental care is a phenomenon that frequently arises in children. Mothers, the main influencers of their children’s development, are thought to be one cause of high anxiety in children. Children with special needs are at a higher risk for developing dental problems. Therefore, an understanding of these children’s levels of anxiety can be used by pediatric dentists to improve dental care.

scholarly journals Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review.

2020 ◽  
Author(s):  
Matteo Melini ◽  
Andrea Forni ◽  
Francesco Cavallin ◽  
Matteo Parotto ◽  
Gastone Zanette
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Meta Analysis ◽  
Dental Anxiety ◽  
Third Molar ◽  
Future Research ◽  
Third Molar Extraction ◽  
Molar Extraction

Abstract Background: Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. Methods: A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen RCTs with a total of 1,788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. Conclusions: This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.

scholarly journals Dental anxiety in patients undergoing oral surgery and its effects on blood pressure and heart rate

2020 ◽  
Vol 9 (8) ◽  
pp. e316985536
Author(s):  
Jaqueline Oliveira Barreto ◽  
Julliana Cariry Palhano Freire ◽  
Arthur Willian de Lima Brasil ◽  
Cristian Statkievicz ◽  
Francisley Ávila Souza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oral Surgery ◽  
Dental Anxiety ◽  
Waiting Room ◽  
Demographic Questionnaire ◽  
Significant Difference ◽  
Before And After ◽  
Evaluation Anxiety

Objective: To assess dental anxiety in patients undergoing oral surgery, as well as its impact on blood pressure and heart rate. Material and Methods: A total of 233 patients answered a socio-demographic questionnaire and another one based on the Corah dental anxiety scale. Blood pressure and heart rate were assessed at three moments while: patients were in the waiting room, immediately before and after the procedure. Results: This study revealed a prevalence of anxiety of 77.3%. There was a statistically significant difference in mean systolic blood pressure and heart rate at the three moments of the evaluation. Anxiety was prevalent in the sample and was observed from the time in the waiting room until the time when local anesthesia was performed, causing variations in systolic blood pressure and heart rate, anxiety levels decreased after the end of the service. In conclusion, we observed that oral surgery is directly related to increased anxiety, and anxiety is mainly related to the change in heart rate.

Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting

2020 ◽  
pp. 159101992097623
Author(s):  
Justin Schwarz ◽  
Ali Al Balushi ◽  
Sri Sundararajan ◽  
Marc Dinkin ◽  
Cristiano Oliveira ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Surgical Procedures ◽  
Medical Management ◽  
Idiopathic Intracranial Hypertension ◽  
Venous Sinus ◽  
Lateral Sinus ◽  
Invasive Treatment ◽  
Blurred Vision ◽  
Surgical Interventions ◽  
Persistent Symptoms

Background Venous sinus stenting (VSS) is an accepted and minimally invasive treatment for adult idiopathic intracranial hypertension (IIH) associated with lateral sinus stenosis (LSS). The efficacy and safety of venous sinus stenting (VSS) in children with IIH has not been established. Methods This is a retrospective analysis of IIH patients 18 years of age or younger with LSS treated with VSS at our institution. Included patients have fulminant disease course or are refractory or intolerant to medical management. Results Eight patients were identified; 4 males and 4 females. Mean age is 13.4 years (range 4–18). All patients had severe headaches, 5 had blurred vision, 3 had diplopia and 3 had pulsatile tinnitus. Papilledema was present in 4 patients. Three patients had prior surgical procedures. Four patients were intolerant to medical management, 3 were refractory and 1 had fulminant course. Cerebral venography demonstrated severe stenosis of the dominant sinus in 6 patients and of bilateral co-dominant sinuses in 2 patients. Six patients had intrinsic stenosis and 2 had extrinsic stenosis. Venous sinus stenting (VSS) resulted in improvement of symptoms, papilledema and normalization of CSF opening pressure in 7 patients. No immediate complications were observed. Mean follow-up period is 21 months (range 6–42). Two patients required re-stenting; one responded well and the other had persistent symptoms and underwent subsequent surgical procedures of CSF diversion, suboccipital decompression and duraplasty which were also ineffective. Conclusion VSS may provide a viable option for pediatric IIH patients who are intolerant to medication, have failed conservative management or prior surgical interventions, or present with fulminant disease.

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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