Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy

2004 ◽  
Vol 28 (4) ◽  
pp. 279-284 ◽  
Author(s):  
Juan Pablo Loyola-Rodriguez ◽  
Ana Alicia Aguilera-Morelos ◽  
Miguel Angel Santos-Diaz ◽  
Veronica Zavala-Alonso ◽  
Claudia Davila-Perez ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
School Setting ◽  
Adolescent And Young Adult ◽  
Dental School ◽  
Discharge Process ◽  
Oral Rehabilitation ◽  
Anterior Teeth

The purpose of this report is to find the use of different alternatives for dental treatment, from general anesthesia to conventional techniques, in patients affected by cerebral palsy (CP) in a dental school setting.The sample was divided into two groups: (1) children, and (2) adolescents and young adults; 38 patients (20 female and 18 male) with diagnostic of CP were included. Risks and benefits of conscious sedation and general anesthesia were written into a consent form and these were discussed with parents or guardians of each affected patient.The mean age was 7.14 ± 2.2 years for children's group and 18.5 ± 3.06 years for adolescent and young adult group.Most children (77.3%) were classified as ASA II with a level of behavior I-II according to Frankl's scale and these patients were treated under general anesthesia (GA). For patients that were classified as of positive behavior with little necessity of dental procedures, independent of the medically compromised level, dental treatment was done with conventional techniques or with conscious sedation. Dental frequency procedures were as follows: composites, dental prophylaxis, and dental extractions in children; in adolescents and adults, important to point out is that in anterior teeth and molars endodontic treatment, and surgical procedures increased in frequency. The mixture sevoflurane-propofol worked well during pre-, peri-, and post-operative procedures. During the discharge process, most patients needed a recovery of 20-40 minutes, after which they were awake and oriented, breathing comfortably with stable vital signs. It was concluded that GA with sevoflurane-propofol and conscious sedation are an excellent tool to provide dental treatment in CP patients in a dental school setting without most of the major postoperative complications, such as nausea and vomiting.

scholarly journals Patient with Down syndrome and implant therapy: a case report

2010 ◽  
Vol 21 (6) ◽  
pp. 550-554 ◽  
Author(s):  
Mônica Regina Pereira Senra Soares ◽  
Fernanda Oliveira de Paula ◽  
Maria das Graças Afonso Miranda Chaves ◽  
Neuza Maria de Souza Picorelli Assis ◽  
Henrique Duque de Miranda Chaves Filho
Keyword(s):  
Down Syndrome ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Central Incisor ◽  
Oral Rehabilitation ◽  
Efficient Treatment ◽  
Obstructive Apnea Syndrome ◽  
Implant Therapy ◽  
Apnea Syndrome

Patients with Down syndrome may not be cooperative during dental treatment and, in cases of complex treatment, it is necessary to use oral or inhaled sedation and/or general anesthesia, which represent safe and efficient treatment resources. There are few reports about oral rehabilitation with dental implants in patients with Down syndrome in the literature. This paper presents the case of a patient with Down syndrome and moderate mental retardation who suffered avulsion of the maxillary left central incisor after a fall, and was treated by means of a single dental implant with immediate load carried out under general anesthesia. After 4 years of follow up, there has been improvement in the sleep obstructive apnea syndrome due to the use of a tongue crib adapted for providing esthetics and preserving the implant placed.

Comprehensive Dental Care of Pediatric Patients Treated Under General Anesthesia in a Hospital Setting in Saudia Arabia

2006 ◽  
Vol 7 (1) ◽  
pp. 79-88 ◽  
Author(s):  
Manal Ibrahim Al-Malik ◽  
Maha Abdulla Al-Sarheed
Keyword(s):  
General Anesthesia ◽  
Dental Care ◽  
Behavior Management ◽  
Pediatric Patients ◽  
Dental Treatment ◽  
Hospital Setting ◽  
Oral Rehabilitation ◽  
Main Indication ◽  
Restorative Treatment ◽  
The Mean

Abstract The aims of this study were to determine the characteristics of patients and type of dental treatment carried out using dental general anesthesia (DGA) during two years in a following three year period. A total of 182 patients received treatment between 1999 and 2001. The mean age was 4.9 years. The main indication for DGA was behavior management problems. Complete oral rehabilitation including complex restorative treatment and extractions was provided under DGA at a single visit. Failure to return for recalls was common; 83% of patients returned for the post-operative recall but only 26% after a three year period. Most of the patients requiring further treatment accepted it in the dental chair. Only one patient received a second DGA during the three years following treatment. Citation Al-Malik MI, Al-Sarheed MA. Comprehensive Dental Care of Pediatric Patients Treated Under General Anesthesia in a Hospital Setting in Saudi Arabia. J Contemp Dent Pract 2006 February;(7)1:079-088.

scholarly journals Cost-effectiveness of Treating Severe Childhood Caries under General Anesthesia versus Conscious Sedation

2018 ◽  
Vol 3 (4) ◽  
pp. 336-345 ◽  
Author(s):  
J.M. Burgette ◽  
R.B. Quiñonez
Keyword(s):  
Cost Effectiveness ◽  
Young Children ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Sensitivity Analyses ◽  
Published Data ◽  
Time Points ◽  
The Cost ◽  
Childhood Caries

Background: Two common methods of treating pediatric dental patients with severe early childhood caries (S-ECC) are general anesthesia (GA) and conscious sedation (CS). We sought to first evaluate the cost-effectiveness of treating S-ECC with GA versus CS and then compare the cost-effectiveness at 2 time points: 2011 and 2015. Methods: We used a decision tree model to produce 2-y estimates of costs and outcomes from the Medicaid perspective. The model cohort consisted of healthy 3-y-olds with S-ECC in need of a theoretical set of dental treatments to be performed under either a single GA visit or 3 CS visits. Outcomes were measured in caries-free months. Costs were evaluated in 2015 US dollars. Costs, probabilities, and outcomes were estimated from published data, expert opinion, and Medicaid billing at an academic health center. One-way and probabilistic sensitivity analyses were performed. Results: As compared with CS, GA resulted in 4 additional caries-free months per child. The cost of a caries-free month for GA versus CS rose from $596 in 2011 to $881 in 2015. These findings were sensitive to loss to follow-up for subsequent CS visits and total cost of GA. Conclusions: Comprehensive S-ECC treatment had better outcomes when performed under GA versus CS. However, GA was not cost saving when compared with CS. While the cost of dental treatment increased for both GA and CS from 2011 to 2015, the cost rose faster for GA. These results have important implications due to the increasing cost to Medicaid insurance and the rising number of young children being treated for S-ECC under GA. Knowledge Transfer Statement: Medicaid policy makers can use the results of this study to evaluate the cost-effectiveness of dental treatment for young children with S-ECC at 2 time points: 2011 and 2015. Compared with CS, GA resulted in a longer amount of time during which children were free from dental caries but at a higher cost. The cost difference rose from 2011 to 2015.

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.

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.

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.

Outcomes of dental procedures performed on children under general anesthesia

2004 ◽  
Vol 27 (2) ◽  
pp. 181-183 ◽  
Author(s):  
Ali Al-Eheideb ◽  
Neal Herman
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Positive Outcome ◽  
High Rate ◽  
Definitive Treatment ◽  
Class Iii ◽  
Posterior Teeth ◽  
Composite Restorations ◽  
Anterior Teeth ◽  
Dental Procedures

The purpose of this study was to evaluate the integrity and longevity of restorative and pulpal procedures performed on primary teeth under general anesthesia (GA). Fifty-four children, who received comprehensive dental treatment under general anesthesia between 1993 and 1995, were included. The postoperative examination period ranged from 6 to 27 months. Children were examined and the quality of the restorations were recorded and evaluated. Behavior problems and inability to cooperate were the main reasons for treatment under GA. Results showed that restoration of posterior teeth with stainless steel crowns (SSC) were more successful (95.5%) when compared to amalgam or composite restorations (50%). In the anterior teeth, strip crowns had a success rate similar to that of Class III, IV and V composite resin materials. Pulpotomies showed an extremely high rate of success (97.1%), while sealants were retained 68.3% of the time. In conclusion, SSC are more likely to be successful and last longer than multisurface amalgam or composite restorations in children treated under general anesthesia. Definitive treatment is more likely to ensure a more positive outcome for children treated under general anesthesia due to less frequent complications from failed restorations or pulpal procedures.

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.

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