Post-sedation Events in Children Sedated for Dental Care

Abstract Moderate oral sedation is used in pediatric dentistry for safe delivery of dental care to children. However, there is a paucity of data on the effects of pediatric dental sedations after discharge of children from the dental office. The purpose of this study was to evaluate and compare the incidence of adverse events occurring with meperidine and hydroxyzine versus midazolam alone 8 and 24 hours after sedation in pediatric dental patients. In this prospective study, a convenience sample of 46 healthy children presenting to a private pediatric dental practice for dental treatment needs was selected. A telephone survey of the parents of children sedated with either meperidine and hydroxyzine or midazolam alone was conducted 8 and 24 hours after the administration of sedation medications. Data analysis included descriptive statistics, frequency and proportion analysis, and Fisher exact test. Forty children were sedated with meperidine and hydroxyzine, and 6 who were sedated with midazolam. In both groups, 50% of the children slept in the car on the way home. Three children in the meperidine and hydroxyzine group vomited in the car. A significantly larger proportion of children in the meperidine and hydroxyzine group experienced prolonged sleep at home (P = .015). More children in the midazolam group exhibited irritability in the first 8 hours (P = .07). There were no statistical differences between the 2 groups with respect to incidence of pain, fever, vomiting, sleeping in the car, snoring, and difficulty in waking up. The lingering effects of orally administered sedation medications can lead to prolonged sleep, irritability, and vomiting in children after they have been discharged from the dental clinic. Most of these events occurred within the first 8 hours, but in some children the effects were seen up to 24 hours later.

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Utility of Bispectral Index Monitoring during Deep Sedation in Pediatric Dental Patients

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.39.1.8882n41g55720155 ◽

2014 ◽

Vol 39 (1) ◽

pp. 291-296 ◽

Cited By ~ 1

Author(s):

C Dag ◽

T Bezgin ◽

N Özalp ◽

G Gölcüklü Aydın

Keyword(s):

Dental Treatment ◽

Deep Sedation ◽

Pediatric Dentistry ◽

P Value ◽

Chi Square ◽

Mean Values ◽

Dental Patients ◽

Physiological Variables ◽

Paired Samples ◽

Significant Difference

Objective: The aim of this study was to compare the total medicament doses and recovery profiles of patients for whom Bispectral Analysis (BIS) monitor was used to monitor sedation. Study design: Thirty-four uncooperative paediatric patients aged 3-6 years who attended to the Department of Pediatric Dentistry for dental treatment were enrolled in the study. Patients were randomly divided into 2 groups of 17 patients each. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded. In one group (BIS-monitored group), drugs were administered to maintain patients’ BIS values between 60-70, while the other group (Non-BIS-monitored Group) was not monitored using BIS. Data was evaluated by Chi-square, Mann Whitney U, Independent Samples t, Paired Samples t and Wilcoxon signed tests, with a p-value of <0.05 considered to be statistically significant. Results: There was no significant difference in total anesthetic doses, incidence of adverse events or recovery profiles of patients between non- BIS-monitored and BIS-monitored groups (p≯0.05). However, distinct correlation was determined among mean values of UMSS and BIS values (p<0.05). Conclusion: BIS represents no advantage over the current commonly accepted methods for monitoring sedation depth in children.

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Dental Phobia

The British Journal of Psychiatry ◽

10.1192/bjp.119.549.151 ◽

1971 ◽

Vol 119 (549) ◽

pp. 151-158 ◽

Cited By ~ 205

Author(s):

Henry Lautch

Keyword(s):

Social Class ◽

Dental Care ◽

Representative Sample ◽

Dental Treatment ◽

Preventive Dental Care ◽

Dental Patients ◽

Family Attitudes ◽

Dental Phobia ◽

Conservative Dentistry ◽

Do So

Although a number of papers have been written emphasizing the need for conservative dentistry and describing various ways of dealing with patients fearful of dental treatment, little systematic attention has been paid to understanding the basis of this impediment. A fear of dental treatment is, indeed, so common that it can almost be considered normal unless of such a degree as to interfere with much needed dental care. Thus, in the U.S.A. Freidson and Feldman (1958) reported that 51 per cent of a large and representative sample did not visit a dentist regularly. Out of these 9 per cent reported that their reluctance to do so was based on fear. Similarly, Kegeles (1963) reported that fear of dental treatment significantly reduced the number of preventive dental care visits, independent of social class. Shoben and Borland (1954) found that unfavourable family dental experience and unfavourable family attitudes towards dentistry were the only factors which discriminated between fearful and non-fearful dental patients.

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HEMOFILIJA A IR B SERGANČIŲ LIETUVOS VAIKŲ BURNOS SVEIKATA IR JĄ LEMIANTYS VEIKSNIAI

Sveikatos mokslai ◽

10.5200/sm-hs.2015.011 ◽

2015 ◽

Vol 25 (1) ◽

pp. 66-71

Author(s):

Rūta Žaliūnienė ◽

Jolanta Aleksejūnienė ◽

Vilma Brukienė ◽

Vytautė Pečiulienė

Keyword(s):

Dietary Habits ◽

Dental Treatment ◽

Dental Health ◽

Economic Status ◽

Study Groups ◽

Salivary Flow ◽

Caries Experience ◽

Healthy Children ◽

Treatment Needs ◽

Increased Risk

Patients with haemophilia often face difficulties in accessing primary dental care: they are at increased risk of spontaneous gum bleeding and significant bleeding from invasive dental procedures. Other of the known barriers is lack of confidence in the ability of dentists to manage patients with haemophilia. The aim of this study was to examine the dental health and its determinants in Lithuanian children with haemophilia and to compare these findings to the general population. Materials and methods. Two study groups were formed: a group of cases, children with haemophilia aged between 4-17 years and a group of controls, randomly selected healthy subjects matched for gender, age and place of residense. The Quantitative Plaque Percent Index (P% index), caries related microflora, stimulated salivary flow rate and buffer capacity, dmf(t), DMF(t) scores were calculated and analyzed. Dietary habits, frequency of tooth brushing, educational and economic level of the parents and type of haemophilia were determined by a questionnaire. Results. Data were collected from 57 children among which 27 were children with haemophilia and 30 healthy controls. Children with haemophilia had lower overall caries experience and less unmet dental treatment needs in deciduous dentitions as compared to their healthy counterparts, but were no differences between the study groups in permanent dentitions. Higher bacteriological counts were found in controls than in study group. Healthy children were from higher socio-economic status families than children with haemophilia. Conclusions. Better dental health was observed in children with haemophilia in deciduos teeth as compared to healthy children. In permanent dentitions overall caries experience and unmet dental treatment needs did not differ between cases and controls.

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Assessing the Need for Anesthesia and Sedation Services in Kuwaiti Dental Practice

Anesthesia Progress ◽

10.2344/0003-3006-57.3.91 ◽

2010 ◽

Vol 57 (3) ◽

pp. 91-95 ◽

Cited By ~ 2

Author(s):

Mohammad Abdulwahab ◽

Fatima Al-Sayegh ◽

Sean G. Boynes ◽

Hawra Abdulwahab ◽

Jayme Zovko ◽

...

Keyword(s):

Public Health ◽

Dental Care ◽

Dental Treatment ◽

Dental Fear ◽

Care Providers ◽

The Public ◽

Dental Patients ◽

Kuwaiti Population ◽

Fear And Anxiety ◽

To Receive

Abstract The objective of this study was to examine the public health relevance of the prevalence of dental fear in Kuwait and the resultant barrier that it creates regarding access to dental care. The study analysis demonstrated a high prevalence of dental fear and anxiety in the Kuwaiti population and a perceived need for anesthesia services by dental care providers. The telephone survey of the general population showed nearly 35% of respondents reported being somewhat nervous, very nervous, or terrified about going to the dentist. In addition, about 36% of the population postponed their dental treatment because of fear. Respondents showed a preference to receive sedation and anesthesia services as a means of anxiety relief, and they were willing to go to the dentist more often when such services were available. People with high fear and anxiety preferred to receive some type of medication to relieve their anxiety. In conclusion, the significance and importance of the need for anesthesia services to enhance the public health of dental patients in Kuwait has been demonstrated, and improvements are needed in anesthesia and sedation training of Kuwaiti dental care providers.

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Niños con hemofilia y su atención odontológica por estomatología pediátrica. Revisión de la literatura / Children with Hemophilia and their Dental Care by Pediatric Stomatology. Review of Literature

Universitas Odontologica ◽

10.11144/javeriana.uo35-74.nhao ◽

2016 ◽

Vol 35 (74) ◽

Author(s):

Ángela Liliana Grandas Ramírez

Keyword(s):

Factor Viii ◽

Dental Care ◽

Hemophilia A ◽

Dental Treatment ◽

Coagulation Factor ◽

Coagulation Factors ◽

Pediatric Dentistry ◽

Review Of Literature ◽

National University ◽

Treatment Considerations

ABSTRACT. Purpose: To carry out systematic review of literature about diagnostics, severity, and dental treatment considerations of children with Hemophilia A. Methods: The search for articles and other document was conducted through the databases available at the National Library System of the National University of Colombia. The English and Spanish terms used in the search were “pediatric dentistry,” “hemophilia A,” dental care,” “coagulation factors,” and/or “coagulation disorders.” Results: The sample consisted of 29 articles that met the inclusion criteria. Hemophilia A is a congenital disorder caused by a deficiency of coagulation factor VIII. Treatment of hemophilia depends on its severity and focuses on avoiding risking life of children due to preventable bleeding by timely applying local therapies such as tranexamic acid or factor VIII, depending on dental needs. Dental treatment of hemophilia A should be interdisciplinary and must emphasize primary health care, health promotion, and prevention in order to avoid invasive dental treatments that could cause bleeding. In addition, treatments seek to maintain oral health and to provide quality of life to children living with hemophilia A.

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Behaviour Evaluation Scales For Pediatric Dental Patients – Review And Clinical Experience

Folia Medica ◽

10.1515/folmed-2015-0006 ◽

2014 ◽

Vol 56 (4) ◽

pp. 264-270 ◽

Cited By ~ 2

Author(s):

Maria P. Shindova ◽

Ani B. Belcheva

Keyword(s):

Dental Treatment ◽

Objective Assessment ◽

Relevant Literature ◽

Pediatric Dentistry ◽

Assessment Tools ◽

Chronological Order ◽

Dental Patients ◽

The Past ◽

Age Range ◽

Assessment Scales

Abstract The present article makes a review of the relevant literature on the scales used in the assessment of behaviour of pediatric dental patients as well as presents the results we have had of using a modified Kurosu Behaviour Evaluation Scale to assess a study sample. The review makes a critical analysis of current evaluation methods and the design of assessment scales. The assessment tools most commonly used in pediatric dentistry are presented in a chronological order from the past to the present. The clinical study we conducted used a modified Behaviour Evaluation Scale developed by Kurosu for the assessment of the behaviour of children. The study showed that during dental treatment of children in the age range of 6 to 12 years the prevailing objective behaviour characteristics in accordance with Kurosu’s behaviour evaluation scale are related to the eyes and the facial expression. The findings from the literature review and the results of our study warrant further studies to develop easy-to-use assessment tools that would enhance the objective assessment of behaviour.

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The Incidence and Nature of Claims against Dentists Related to Periodontal Treatment in Israel during the Years 2005–2019

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084153 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4153

Author(s):

Dima Nassar ◽

Nirit Tagger-Green ◽

Haim Tal ◽

Carlos Nemcovsky ◽

Eitan Mijiritsky ◽

...

Keyword(s):

Periodontal Disease ◽

Dental Treatment ◽

Categorical Variables ◽

P Value ◽

Fisher Exact Test ◽

Final Decision ◽

Chi Square ◽

Exact Test ◽

Malpractice Claims ◽

Dental Practitioners

Background: In recent years, worldwide dental malpractice claims have dramatically increased. The purpose of the present study is to analyze periodontal therapy related claims in Israel that led to legal decisions. Methods: This retrospective cohort study includes malpractice claims against dental practitioners related to periodontology between 2005 and 2019. Only closed cases where a final decision was made were included. The chi-square test or Fisher exact test for categorical variables were performed and a p value of <0.05 was considered statistically significant. Results: During the study period there were 508 legal claims related to periodontal disease. Most plaintiffs were women (63.4%), and 71.3% of the patients were >35 years old. Most claims (82.8%) were settled out of court and ended in compromise. Claims concerning the treatment of periodontal disease by periodontists accounted only for 4.5% (23/508) of the cases while 95.5% (485/508) of the claims were for complications secondary to another treatment. Prosthodontic treatment was involved with the highest number 54.5%, followed by dental implants 17.7%, and endodontics 11.6%. The allegations were related to pain and distress (84.8%), aggravation of existent periodontal disease (83.3%), tooth loss (78.1%), and violation of autonomy (47%). Conclusions: The main cause for lawsuits was related to aggravation of periodontal disease during prosthetic or implant therapy and related to suspected faulty or inexistent preoperative diagnosis and planning. Practical implications: Periodontal consultation before dental treatment may reduce malpractice risks, adverse events, and un-necessary changes of treatment plans.

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Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa

Children ◽

10.3390/children8020120 ◽

2021 ◽

Vol 8 (2) ◽

pp. 120

Author(s):

Abbas Jessani ◽

Mir Faeq Ali Quadri ◽

Pulane Lefoka ◽

Abdul El-Rabbany ◽

Kirsten Hooper ◽

...

Keyword(s):

Public Schools ◽

Health Status ◽

Oral Health ◽

Service Utilization ◽

Southern Africa ◽

Dental Care ◽

Dental Treatment ◽

Oral Health Status ◽

Dental Service ◽

Treatment Needs

This study aimed to characterize the best predictors for unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa. A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate, and multivariate regressions. Five hundred and twenty-six survey responses and examinations were gathered. The mean age of student participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n = 355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous two years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Our results suggest that access to oral health care is limited in Lesotho. Further patient oral health education and regular dental care may make an impact on this population.

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Behavior and reaction of children to dental care, when submitted to play workshops before and after treatment

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-86372020000413614 ◽

2020 ◽

Vol 68 ◽

Author(s):

Laura SOUZA ◽

Filipe NOGUEIRA ◽

Laíza MARTINS ◽

Danielly FERREIRA ◽

Fabiana OLIVEIRA ◽

...

Keyword(s):

Child Behavior ◽

Dental Care ◽

Positive Emotions ◽

Dental Treatment ◽

Cooperative Behavior ◽

Negative Emotions ◽

Pediatric Dentistry ◽

Before And After ◽

Three Stages ◽

The One

ABSTRACT Objective Strategies to prepare the child with play activities in order to establish an initial friendly relationship between patient and dentist are widely used as a means to soften the inconsistent behaviors and negative emotions during dental treatment. Thus, the objectives of this study were to evaluate the emotions of children before and after performing play activities and at the end of dental treatment, as well as assessing child behavior. Methods A total of 74 children, both boys and girls, aged 4 to 10 years old, participated in this study and attended the Pediatric Dentistry Clinic for two consecutive semesters. The children responded as they felt through the Emotions Deck during the three stages. In addition, data on behavior and procedures were also collected. Results A total of 468 emotions were evaluated, of which 69 (14.75%) were negative and 399 (85.25%) were positive; the joy was the one of greater frequency in the three evaluated moments. A total of 128 (82.05%) positive emotions were observed before, 133 (85.25%) after the play activities and 136 (87.18%) of the positive emotions were after the dental treatment. As for negative emotions, 28 (17.94%) were before, 23 (14.74%) after play activities and 20 (12.82%) after treatment. Regarding behavior, only 9 (5.77%) were not registered as cooperative, while 147 collaborated (94.23%). Conclusion Therefore, it was possible to conclude that the majority of the patients presented positive emotions at the different moments evaluated and the negative emotions were observed mainly before the ludic activities, having a reduction after the dental care. Most patients demonstrated cooperative behavior.

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O uso de desenhos como técnica projetiva em odontopediatria

Revista da Faculdade de Odontologia de Porto Alegre ◽

10.22456/2177-0018.102663 ◽

2020 ◽

Vol 61 (2) ◽

pp. 103-112

Author(s):

Larissa Moreira Pinto ◽

Stéffani Serpa ◽

Natália Baschirotto Custódio

Keyword(s):

Clinical Practice ◽

Dental Care ◽

Preventive Measures ◽

Dental Treatment ◽

Pediatric Dentistry ◽

Projective Techniques ◽

Pediatric Dentist ◽

Effective Instrument ◽

Positive Return ◽

Dental Environment

The dental environment can be considered a stressor for children, and can trigger unwanted behaviors. Pediatric Dentistry is a specialty that requires professionals to know preventive measures and restorative skills to perform dental treatment in children or adolescents. In addition, it is especially important that the professional is concerned with the child’s feelings and reactions, allowing the pediatric dentist to identify situations that may generate stress for the patient during the care, and manage the presented behaviors. Recent studies have measured children’s reactions and feelings during dental treatments using projective techniques. Given the importance of drawing to identify children’s emotions, the objective of this study was to search the literature about the use of drawings as a projective technique in Pediatric Dentistry. Therefore, projective techniques, with an emphasis on drawing, have proved to be an effective instrument to be used in clinical practice to better understand the reactions presented by children during dental care and their relationship with dentists. Thus, avoiding unexpected situations in the office and allowing greater chances of obtaining a positive return from the patient.

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