scholarly journals Predictable sedation: Safe administration of oral Midazolam and nitrous oxide gas for paediatric patients in the general dental practice

2021 ◽  
Vol 76 (08) ◽  
pp. 471-476
Author(s):  
Nicoline Potgieter ◽  
Günther Streit
Keyword(s):  
Nitrous Oxide ◽  
Dental Health ◽  
Review Literature ◽  
Health Providers ◽  
Behaviour Management ◽  
Dental Patients ◽  
Paediatric Patients ◽  
Oral Midazolam ◽  
Nitrous Oxide Oxygen ◽  
Hypnotic Agent

Behaviour management for anxious paediatric dental patients is challenging. Solutions include education and sedation. Various drugs have been used to effectively sedate paediatric patients during treatment. The aim of this study was to review literature on the sedation of paediatric patients. The study specifically looked at those reviews covering the combination of two sedation methods in case of more challenging paediatric patients. The study undertook a literature review focused on studies using nitrous oxide, Midazolam, or a combination of the two substances. An electronic search was done on EBSCOhost to source articles published from 1979 to 2019. A deeper form of sedation can be achieved for paediatric patients when using a combination of nitrous oxide, oxygen and a hypnotic agent such as Midazolam. Dealing with the anxiety levels of paediatric patients is a challenge for dental health providers. Two of the main strategies used to deal with anxious children are behaviour management and sedation. A critical review of journal articles on the use of nitrous oxide and oxygen in combination with Midazolam was therefore undertaken. The findings suggest that, in order to achieve a deeper form of sedation, the combination of nitrous oxide, oxygen and Midazolam works well to reduce discomfort, anxiety and/or pain in paediatric patients.

scholarly journals Comparison of Nitrous Oxide-Oxygen as Inhalation Agent, Midazolam, Ketamine alone and in Combination as Oral Sedative Agents for In-office Paediatric Patients- A Randomised Control Trial

2021 ◽  
Author(s):  
Monika Nagpal ◽  
Mohan Lal Khatri ◽  
Anil Gupta ◽  
Ankit Srivastava ◽  
Shalini Garg
Keyword(s):  
Nitrous Oxide ◽  
Local Anaesthesia ◽  
Randomised Control Trial ◽  
Old Patients ◽  
Oxygen Saturation Level ◽  
Oral Ketamine ◽  
Paediatric Patients ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Nitrous Oxide Oxygen

Introduction: In-office pharmacological sedation techniques are best applied to manage an extremely fearful preschooler, especially during primary dentition or a child’s early mixed dentition period. These should be used when non pharmacological behavioural management techniques fail either due to lack of communication or in children with special care needs. Aim: To compare the efficacy of oral administrations of midazolam, ketamine, combination of midazolam-ketamine (M+K) and nitrous oxide-oxygen (N2O) inhalational sedation in achieving favorable behavioural outcome compared by using the Houpt scale in the treatment of anxious and uncooperative paediatric patients. Materials and Methods: A randomised clinical trial was conducted in the Department of Paediatric and Preventive Dentistry, SGT University, Haryana, India between September 2018 to December 2019. The study included 100 anxious children (Venham’s picture scale) aged three to five years, who required procedures under local anaesthesia administration were divided into four groups using envelop method. Each group was given either oral midazolam (M) (0.3 mg/kg) or oral ketamine (K) (3 mg/kg) or oral combination of midazolam+ketamine (M+K) (0.3 mg/kg and 2 mg/kg) or inhalational nitrous oxide-oxygen (N2O). The behaviour response of the child was recorded using the Houpt scale. The oxygen saturation level and heart rate of each patient were also recorded before, after, and during the procedure. Adverse drug reactions post-treatment was also recorded. Analysis of Variance (ANOVA), Chi-square test and Mann-Whitney U test was used for statistical analysis. Results: The study comprised of 100 anxious children (mean age was 4.1±0.5 years) requiring administration of local anaesthesia with intent to complete in-office treatment. Statistically, a significant difference was found among behaviour outcomes of four groups (p-value=0.047). Acceptable behaviour was seen best in K+M group (88%), followed by oral ketamine (K) (68%), N2O (59%), and oral midazolam (M) (52%). Adverse reactions were most commonly seen in the oral ketamine group. Conclusion: Oral M+K combination group is significantly better than oral ketamine (K), oral midazolam (M) or N2O inhalation sedation to achieve the required behaviour for dental treatment in three to five years old patients.

Nitrous oxide-oxygen or oral midazolam for pediatric outpatient sedation

2002 ◽  
Vol 93 (6) ◽  
pp. 643-646 ◽  
Author(s):  
Sarah A. Hulland ◽  
Marshall M. Freilich ◽  
George K.B. Sàndor
Keyword(s):  
Nitrous Oxide ◽  
Oral Midazolam ◽  
Nitrous Oxide Oxygen

scholarly journals A Preliminary Study of the Treatment Outcomes of Paediatric Dental Patients Referred for General Anaesthesia or Sedation at a Regional Hospital in Trinidad

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 876
Author(s):  
Tricia Percival ◽  
Reshma Bhagoutie
Keyword(s):  
Treatment Outcomes ◽  
General Anaesthesia ◽  
Dental Health ◽  
Regional Hospital ◽  
Behaviour Management ◽  
Dental Patients ◽  
Mean Waiting Time ◽  
Receive Treatment ◽  
The University

General anaesthesia and sedation are known to be useful adjuncts in the care of paediatric dental patients. There are several challenges that prevent patients from receiving care. Aim: To assess the treatment outcomes of paediatric dental patients seen at an emergency facility who were referred for treatment under sedation or general anaesthesia at a regional hospital in Trinidad. Methods: Records of patients seen at the Child Dental Health Unit Emergency clinic at the University of The West Indies Dental School from 2012 to 2017 were assessed. The parents of children referred for general anaesthesia or sedation at the regional hospital were then interviewed via telephone. Results: Most children (53.4%) were younger than 6 years old and the most common reasons for referral were the treatment of multiple carious teeth and behaviour management. Furthermore, 66.1% of cases did not receive treatment and had a mean waiting time of 4.7 years, and 61.7% of referred cases needed emergency care while awaiting general anaesthesia or sedation. Limited access to these services and the high cost of treatment were the main reasons for non-treatment. Conclusion: There is significant need for the timely treatment of paediatric dental patients referred for general anaesthesia or sedation. Improved availability and accessibility of these services could improve patients’ quality of life.

scholarly journals Use of nitrous oxide‐oxygen inhalation sedation in the COVID‐19 era

2021 ◽  
Vol 31 (3) ◽  
pp. 433-435
Author(s):  
Kunal Gupta ◽  
Dimitrios Emmanouil ◽  
Amit Sethi
Keyword(s):  
Nitrous Oxide ◽  
Inhalation Sedation ◽  
Oxygen Inhalation ◽  
Nitrous Oxide Oxygen

scholarly journals Behaviour and Anxiety Management of Paediatric Dental Patients through Virtual Reality: A Randomised Clinical Trial

2021 ◽  
Vol 10 (14) ◽  
pp. 3019
Author(s):  
Cristina Gómez-Polo ◽  
Ana-Aida Vilches ◽  
David Ribas ◽  
Antonio Castaño-Séiquer ◽  
Javier Montero
Keyword(s):  
Virtual Reality ◽  
Dental Treatment ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Chi Square ◽  
Anxiety Management ◽  
Dental Patients ◽  
Paediatric Patients ◽  
Chi Square Test ◽  
Scale Test

Clinicians should appreciate the effectiveness of virtual reality (VR) headsets for managing both the anxiety and the behaviour of non-cooperative paediatric patients who require treatment over several dental appointments. The aim of this study was to assess the effectiveness of using a VR headset as a distraction for managing the anxiety and behaviour of paediatric patients during their dental treatment. Eighty patients, aged between five and ten years old and who required dental treatment over three or more appointments, were randomly allocated into two groups. One group used a VR headset during all their appointments, and the other one did not use any distraction technique. The patients were asked to take a Facial Image Scale Test during their first and last appointments to assess their level of anxiety. Additionally, the dentist completed the Frankl Test to quantify the child’s behaviour at the beginning and the end of their treatment. The results obtained, both from the group using the VR headset and from the control group, were compared using the chi-square test. The use of a VR headset during dental treatment significantly reduced anxiety (95% of the children were happy) and improved behaviour (100% positive behaviour) as compared with the control group (40% and 57.5%, respectively). A VR headset can effectively distract a paediatric patient, helping to reduce anxiety and manage behaviour during dental treatment

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